Month: January 2008

“Mr. Tilney! Have a care with my name – you will wear it out!”

James Kirchick’s article revealing the many instances of racist, homophobic, and anti-Semitic commentary in Ron Paul’s newsletters over the last two decades is damning. I’m willing to consider the possibility that these were ghostwritten without his input, although the best conclusion is that he has very poor skills in exercising judgment and oversight. Those are not winning attributes for a president. Regardless, since I haven’t supported Rep. Paul’s candidacy, I feel no need to justify or defend him further. I’m more interested in the larger issue.

From Radley Balko, at Hit & Run:

Of course, Paul was never going to win. So the real concern here is what happens to the momentum for the ideas his campaign has revived. The danger is that the ignorance in those newsletters becomes inextricably tethered to the ideas that have drawn people to Paul’s campaign, and soils those ideas for years to come.
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I also fear that newly-minted Paulites on sites like Reddit, Digg, Slashdot and the like—whose first exposure to libertarianism was Ron Paul—are going to click over to the New Republic piece in the coming days, become disillusioned, and assume that this is really what libertarianism is all about.
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Paul’s success and media coverage have exposed a large portion of the country to libertarian ideas for the first time. Before yesterday, that was a good thing. But now I’m not so sure. If this new audience’s first exposure to libertarianism now comes with all of this decidedly unlibertarian baggage—that many may now wrongly associate with libertarian ideas—maybe it would have been better if Paul’s campaign had sputtered out months ago, and we waited a cycle or two for someone else to come along to tap the sentiment.

From an Andrew Sullivan reader:

The backlash from all of this will be harsh, no doubt. It might even leave a long-lasting mark on libertarian conservatism. I think we deserve it.

Sensible libertarians do not deserve any such backlash. I have not run wild promoting Rep. Paul just because I wanted to see what I value reflected in his campaign when it was never there. Maybe it’s a cynicism I’ve developed from looking at how government works and how people with illiberal, anti-liberty positions manipulate the government that made me skeptical of Paul. I’d say it’s probably more a wonkish desire to know details. I can’t claim perfection there because I do have a filter. But when a candidate like Paul espouses ideas that are flawed so close to the surface, I’m not willing to set aside critical thinking in favor of enthusiasm and hope.

I don’t think the problem has been libertarians supporting Rep. Paul. We all make compromises at some point. But we must be honest about them. We should talk about ideas, and when something makes them more possible to discuss in public forums, we should seek to use that opportunity. Still, labels matter. With even a cursory look at his positions, it was always clear that Rep. Paul is not a libertarian.

So now the careless have hitched our principles to an unstable vehicle of political expediency. Why? We knew that we weren’t getting a libertarian president in November, even if Rep. Paul was a libertarian. We’re often accused of being too rigid in adhering to how little government should do. There is no justification for abandoning that rigidity at the first whiff of minor success in the public consciousness. First impressions.

Now I’m angry at being forced into guilt-by-association. Thanks.

P.S. Title reference here.

Joe Gibbs Resigns

Consider my response to this news the polar opposite of my joyous response four years ago.

Even though he didn’t achieve the results we all hoped for, I’m thankful for the new memories. Although the Sean Taylor’s death was unacceptably tragic, we were able to remember how Coach Gibbs is great. Some things really are bigger than sports. Still, he allowed Redskins prestige to return. The pieces for success are in place. Someone new (*cough*Bill Cowher*cough*) will have to win with them, but the last four years were far from fruitless.

Thanks, Coach Joe.

Proxy consent is a valid concept, in the proper context.

I’ll leave the libertarian angle of this story to others, Radley Balko among them because that’s where I found it first. I have a different analysis to make.

An armed law enforcement team broke down the door of a family home with a battering ram and took an 11-year-old to a hospital after authorities feared he was not getting proper medical care for what turned out to be a minor head injury.
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Jon’s father, Tom Shiflett, 62, told paramedics he didn’t want them to treat Jon and asked them to leave. He told them he had served as a medic in Vietnam and he had the skill to treat his son.
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Following the raid, a doctor recommended Jon be given fluids, Tylenol and ice to treat the bruises, according to a copy of the child’s patient aftercare instructions.

This is an example of where proxy consent for parents is appropriate. This is the determination of medical need, based on actual evidence to suggest that injury might exist. It is logical to determine whether or not intervention is necessary. Contrary to other decisions we incorrectly permit.

It’s early January? It’s Dale Murphy time again.

The Baseball Writer’s Association will continue ignoring Dale Murphy for the Hall of Fame when it releases this year’s voting later today. I will continue writing posts supporting Murphy’s candidacy. And like every year, I will recycle each year’s format and quote the sanity of Jayson Stark.

And the forgotten stars of the ’80s keep on coming. No player of his generation has been more outspoken about the steroids era than Murphy. And, sadly, it’s possible that no great player has had more damage done to his candidacy by that era — and its inflated numbers — than Murphy, either.

His 398 homers and that .469 career slugging percentage look downright ordinary nowadays. But remember, this is supposed to be about what these men did in their era. And back in the ’80s, Murphy led all National Leaguers in runs and hits, tied Mike Schmidt for the most RBIs and finished second to Schmidt in home runs. He also was a back-to-back MVP, a five-time Gold Glove winner, a proud member of the 30-Homer 30-Steal Club, a guy who once got more All-Star votes than anyone else in the whole sport and one of the classiest clubhouse citizens ever.

Every voter who votes against Mark McGwire should be required to vote for Murphy. Otherwise, the ballot is nothing more than a forum for bias and moral preening.

Actually, the ballot is already about that. It shouldn’t be, but the evidence tells the truth. No one admits it. Nor do they acknowledge the logic of what Mr. Stark wrote about Jim Rice’s candidacy in the same column. He could’ve written it directly about Murph, as well, as I have many times.

I keep waiting for the backlash against the steroids era to start working in the favor of players like Rice. It hasn’t happened yet. But backlash or no backlash, we’re supposed to be comparing players to other players in their time, not anybody else’s time.

That’s the only criteria for statistics.

I can’t wait to see how many writers botch it this year. Not that it matters. Murph is in his tenth year of eligibility. He has five years left after this vote. Many worthy players trend to election as their eligibility wanes. Goose Gossage is the current example. And Murph reversed his downward slide last year, so Hopefully Murph will start to get more respect. But I don’t believe he’ll ever reach election via the writers. The process is too subjective and in the hands of incompetents. His only hope rests with the Veterans’ Committee. I don’t know how much hope to place in that, but his chances can’t be worse there.

Go Murph!

Update: I’ve fixed one inaccurate sentence, since Murphy’s vote total declined last year. However, he received 75 votes this year, up from last year’s 50!

Subjective evaluations require only the individual.

The mindlessness of both research and reporting about circumcision is exhausting. I fear this story is going to be the new gold standard for the smug dismissal of any challenge to pro-circumcision advocacy. Consider:

Circumcision does not reduce sexual satisfaction and so there should be no reservations about using this method as a way to combat HIV, a study says.

Nearly 5,000 Ugandan men were recruited for the study. Half were circumcised, half had yet to undergo surgery.

There was little difference between the two groups when they were asked to rate performance and satisfaction, the journal BJU International reports.

Ehhhhhhhhhhhhh. The ways this is going to be abused by those who’d rather cheer their reality-free position than think their way into an honest conclusion that recognizes medicine and ethics…

Sexual satisfaction is a subjective measure, unique to each person. Collective judgments are irrelevant.

The men in the study are adults volunteering for the surgery. Don’t read more into it than that.

These results do not change the medical and ethical issues surrounding infant circumcision.

There is a difference in the skin of a freshly healed circumcision and a circumcision that occurred in infancy many decades ago. The former is still pink and moist. The latter is keratinized and tough. This is not open to debate.

Par for circumcision advocacy reporting, the article immediately restates that (volunteer, adult) circumcision may reduce the risk of female-to-male HIV infection. It leaves out most of that specificity, of course. Consider what the journalist reports on how (voluntary, adult) circumcision may achieve this result.

Specific cells in the foreskin may be potential targets for HIV infection, while the skin under the foreskin may become less sensitive and less likely to bleed – reducing risk of infection – following circumcision.

In any other academic pursuit, such obvious contradictions would be called out and the position advocated on faulty thinking would be dismissed. These two claims conflict. (Voluntary, adult) circumcision doesn’t affect sexual satisfaction, but it might reduce sensitivity. So which is it?

Still, we must focus on circumcision as an individual procedure. The study found the following:

Some 98.4% of the circumcised men reported satisfaction, compared to 99.9% in the control group.

And so on, with the reported caveat that these differences aren’t clinically significant. That doesn’t matter for the individual.

I don’t have the numbers, so I’ll use assumptions based on what’s reported. I’ll assume 5,000 adult men volunteering for the study, with 2,500 in each group. So, of 2,500 voluntarily circumcised adult males, 2,460 are happy with the results. That leaves 40 men who are not satisfied. For those 40 men, they can claim “oops” and have that suffice. If the study’s findings hold for infant circumcision, which I doubt on a one-to-one comparison, “oops” is not sufficient to justify the implied harm done to those 40 males circumcised as infants at the decree of their parents.

The Obvious Drawback to Educating Via Lists

This article demonstrates how most media irresponsibly reports on issues surrounding infant circumcision. The Pro list:

  • Reduces risk of urinary tract infections.
  • Reduces risk of contracting STDs (still under debate. A recent study in South Africa found that circumcision may reduce HIV transmission, but the study was not completed.)
  • Reduces risk of penile cancer.

The caveat on point two is shocking because most media outlets are far too breathless to include that. But notice the complete lack of context on the risks listed. The article mentions a bit of context that the actual risk of UTIs and penile cancer are tiny, so why not include that in the list? The support becomes even less compelling when context is included.

The Cons:

  • The foreskin is densely packed with nerves and blood vessels and forms a protective covering over the head of the penis. It also provides lubrication. Many advocates claim that removing it therefore reduces sexual sensitivity.
  • Circumcision has led to complications from excessive bleeding and infection in the past. But many say that complications resulting from circumcision are far fewer than those averted by it.

I don’t believe the qualification on point one is necessary. The basic fact leads to one logical conclusion. Anecdotal evidence also seems to readily verify this statement. But I understand the contention over the issue.

There is no excuse for the qualification in the second point. Circumcision is an individual surgery. The risk of complications applies to each individual circumcised, regardless of the reason. People believe that circumcision is safe. I’ll set aside my factual claim that it causes harm in 100% of instances and accept that such a belief is statistically supported in the collective.

But complications occur. It is not fool-proof. The existence of inherent surgical risks requires that we bring the issue to medical need alone. Adding the caveat permits people to incorrectly believe that the potential benefits outweigh the potential complications. (Risks are not potential.)

Also, since no context is offered for the earlier benefits, stating now a conclusion from a cost-benefit analysis is poor journalism. If the article does not provide the analysis, it can’t responsibly provide the conclusion.

**********

The article concludes with this:

Dr. Stephen Wainer, a pediatrician at the Peter Lougheed hospital, feels many people are giving the issue more attention than it’s worth.

“In the greater scheme of things, it’s a trivial issue,” says Wainer, who routinely performs circumcisions.

Perhaps it’s interesting that Dr. Wainer believes unnecessary infant circumcision is a trivial issue. So what? His patient’s opinion is the only opinion that matters. Dr. Wainer doesn’t ask his patients because they can’t give their opinion. Their opinions may be no less subjective that Dr. Wainer’s stance, but that doesn’t matter. The patient’s opinion is the only opinion that medically and ethically matters.

The individual will be discarded in November 2008.

While not automatically opposed to a presidential candidate giving sermons, Mike Huckabee scares me. Giving a guest sermon at a church in New Hampshire yesterday, he said:

“When we become believers, it’s as if we have signed up to be part of God’s Army, to be soldiers for Christ,” Huckabee told the enthusiastic audience.

That mindset will reverse the push to Christianize the United States Military. I’m not interested. I don’t have a problem with religious soldiers, but our military must remain secular. We’re already too close to destroying that. Huckabee is not a step away from the brink.

“When you give yourself to Christ, some relationships have to go,” he said. “It’s no longer your life; you’ve signed it over.”

Likening service to God to service in the military, Huckabee said “there is suffering in the conditioning for battle” and “you obey the orders.”

Huckabee’s economic populism reflects this. Citizens sign their lives over to the state so that the state may save them, including those who don’t vote for Huckabee. Even if it doesn’t reach into religion, the state knows better what you should and shouldn’t do.

The debate ignores this, but honesty would acknowledge it.

Fill in the blank:

“I didn’t feel nervous, because I had spent years watching how the cut was done,” [Amina] Khidir remembers. “And my              was a baby at the time, too small to understand what was happening. That’s the best age to do it.”

The missing word is daughter.

Asked about the specifics of the procedure, she covers her face with her loosely worn headscarf. “I cut about a quarter off,” she says.

How do we (correctly) label females as victims under that logic, yet males subjected to identical logic and outcome are not victims, but rather the beneficiaries of compassionate parents?

Random Thoughts on Last Night’s Democratic Debate

I didn’t realize the ABC debate was last night. Knowing about them normally wouldn’t change my lack of desire to watch them, but I was in an angry stupor from watching the Redskins destroy the Seahawks themselves. I was in a mood to watch something that would make me angry, so I stuck around when I turned it on. I missed the Republican portion of the “1 Night, 2 Parties” scheme because of the game, but really, so what? There’s only one guy there I’d consider voting for, and I’ve already explained several reasons why I won’t vote for him. Even then, none of them stands a decent chance of winning, unless the Democrats stay as stupid and spineless as they’ve proven over the last few years. Based on last night’s debate, they could go either way.

I’m writing from memory, as I didn’t take notes and don’t feel like reading the transcript. With that, the candidates:

Sen. Barack Obama
He knows it will sell to claim that we can fix Social Security by eliminating the wage cap. I have no doubt he also knows this is disingenuous to any claim of fairness. Social Security is already progressive, aside from being obscenely ineffective. “The rich” do not receive the same return on their taxes. Their benefits are means-tested to shift some of their taxes to “the poor”. Eliminating the wage cap will only make the system more progressive. Any talk of “the rich” paying their fair share is a lie.

Sen. Obama was very effective at answering the likability question. He managed to disarm the crowd and moderator with talk of the Redskins and general chit-chat. In the talk of writing, he showed what Clinton said.

It proves nothing about his ability to be president, of course, but as Sen. Clinton said, people voted for Bush because they would like to have a beer with him. I don’t think Clinton misunderstands the value of this point; she’s just incapable of exuding likability.

Also, his honesty that a cap-and-trade system would cause harm was good. He’s wrong about cap-and-trade, but at least he’s only partially delusional.

Sen. Hillary Clinton
I didn’t like her before, and I don’t like her after. I didn’t learn anything new about her other than she really, really believes her own marketing and the silly idea that wanting something to happen in Washington means it’s a foregone conclusion. And, she’s scared. She spent the entire evening attacking Sen. Obama with rambling, non-linear attacks that left him with too many opportunities to pick and choose his rebuttal. He did. Even Edwards defended him. She’s toast, so I’m done worrying about her.

Gov. Bill Richardson
He has a decent notion of what a principle might be, which is a welcome change. But he’s mental on foreign policy. I’m not sure he has a great grasp on domestic policy, either. I found myself thinking, “I like him. Too bad he’s not doing better.” Then I remembered that the vote is for president. No.

Former Sen. John Edwards
He’s gotten slicker, in the most non-complimentary way. He’s a snake-oil salesmen to his core. It’s very personal for him, as he reminded us many, many times. Government can do anything if the president just cares hard enough.

He’s a complete economic populist. I don’t understand how people find his pitch reasonable. He wants to fight for all American people against the evil corporations and special interests. And “the rich”. Right, but aren’t they Americans, too? This is how he demonstrates that equality isn’t about equal. I’m not interested.

I also thought he had the stupidest mistake of the night. The other candidates should’ve jumped on him when he gave examples that he doesn’t hate all corporations. AT&T? The same AT&T that helped the Bush Administration circumvent the Constitution and spy on Americans without warrants? Surely helping its workers unionize (Really?) isn’t comparable. Caving to a calculated talking point rather than expressing an in-depth understanding of an issue is not a quality I want in a president.

Finally, Edwards used the case of Nataline Sarkisyan:

Doctors for 17-year-old Nataline Sarkisyan wanted to give her a liver transplant, but her insurer, Cigna HealthCare, initially denied their request on grounds that the transplant was too experimental. Nataline, a leukemia patient, was in intensive care at UCLA suffering from complications of a bone marrow transplant.
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Stripped of backgrounds and reduced to sound-bite scale, Natalie’s story sounds like it could have been scripted by Michael Moore. But as the Los Angeles Times noted, Cigna had “tough calls” to make. It was far from clear that the requested liver transplant would do any good. Even Natalie’s doctors at UCLA judged that she would have had a 65% chance of living six more months — not a strong chance of long-term success.

Dr. Stuart Knechtle, who heads the liver transplant program at the University of Wisconsin, Madison, says transplantation is not an option for leukemia patients because the immunosuppressant drugs used in such procedures tend to spur the growth of cancer cells (he was not commenting specifically on Nataline’s case).

Clearly Edwards is saying that universal/single-payer health care would’ve approved the transplant. Fine, make that argument. But now explain to me how that lowers the cost of health insurance. There will be other tough cases. The choice is rationing or extensive experimental care. We’ve currently opted more to experimental than rationing, which is why our costs are higher than other countries. But we get something for that. We can’t have both. So which is it?

I don’t walk away from the debate with a different opinion on how badly single-payer health care would go. Health care reform, as it’s currently discussed, is a populist effort. Politicians do not have it in them to say “no” to any requests. Everyone and everything is validated as worthwhile. Such thinking has consequences and they’re predictable.

One final point on Sen. Obama regarding health care. He touted his plan’s lack of a mandate for adults (he mandates for children), saying that adults can choose. Agreed, but why is that not transferable to every other policy proposal? Why do I not get a choice with Social Security, for example?