Denialism Blog

  • Huffpo Science – already slipping into anti-science

    Our initial optimism over Huffpo science being a haven for reason in a den of disease-promotion and quackery appears now to be misplaced. It appears the animal rights cranks have made inroads with Bruce Friedrich, a member of PETA and advocate of animal liberation, who has jumped from Huffpo “green” to Huffpo “science”. The science gatekeepers at Huffpo have clearly failed.

    Writing about “Speciesism: The Movie”, he exposes the anti-science ideology of the animal rights movement, and Huffpo science doesn’t seem to have noticed:

    Every now and then, a movie comes along that is capable of fundamentally changing the worldview of its audience. Speciesism: The Movie, a new documentary by Mark Devries, is that kind of film.

    The word “speciesism,” which has been popularized by Princeton bioethicist Peter Singer, refers to the assumption that a vast gulf exists between the ethical value of human interests and the ethical value of the interests of other animals. At its extreme, we may see ourselves as the only species that matters morally, and view other animals as existing merely for our use: to eat, to make into clothing, to perform experiments on, to be entertained by in circuses and zoos. Like those who grew up having overt racist beliefs assimilated into their worldview, some degree of speciesism has been so well-assimilated into the worldview of most of us that it does not even appear to be worth questioning.

    Devries goes to great lengths to put together a thoughtful and entertaining film–whether commissioning an airplane to fly over factory farms’ giant “manure lagoons” with an anti-CAFO Republican from North Carolina, or (somehow) scheming his way into receiving a guided tour of a factory farm.

    Along the way, he meets and questions a remarkably broad range of people, including Peter Singer (whom the New Yorker has named “one of the most influential philosophers alive”), Richard Dawkins (the most influential evolutionary biologist of the past century), and Temple Grandin (designer of the animal handling systems used by over half of the slaughterhouses in the United States).

    He also speaks with anti-factory farming activists, a man who is dying next to a huge hog farm, a current member of the American Nazi Party, a disability rights activist, a vivisector, quite a few people on the street, and more–all in his quest to thoroughly consider the philosophy that says that bias on the basis of species is unjustifiable. Disclaimer: He also spoke with me.

    Above all, Devries confronts some very difficult and uncomfortable questions head-on. For example: How strong are the grounds for believing that humans have special moral worth? How valid are the comparisons between our use of other animals and the slavery of other humans?

    My emphasis added. So here we have it on Huffpo science. Believing that our species should be valued over other species is a sin equivalent to racism. Use of other animals is like slavery. Biologists aren’t scientists we’re “vivisectors”. We’re all going to hell.

    To be clear, biological science without use of animals is impossible. It’s not just toxicity testing of drugs either, and we are fully aware of the limitations of our animal models, thankyouverymuch. But from the ground up, the study of life depends on the use of living things. From the cells we harvest for culture (we can’t all study wacky immortalized cancer cells you know), to the serum we grow them in, to the antibodies we generate by exposing animals to antigens, to the transgenic animals we use to study genes in vivo, to the model animals that modern surgical techniques and technologies are refined in, biological science is intimately tied to living things. The face transplant I wrote about yesterday? Impossible without prior animal modeling, practice with surgical technique and molecular investigation of immunosuppression. Transplant in general? The earliest investigations of skin grafting and surgical techniques for transplant were honed in animals – with some hefty human experimentation as well. Every major surgical advance, medical advance, and plain basic biological science knowledge comes from our manipulation of the living things around us. But are we in any way noble for our pursuit of knowledge, for yes, explicitly human benefit? No, we’re speciesist, we’re vivisectors.

    Well fine, I admit it. I value human life over that of other species. I’ve devoted my life to saving human lives, and as a scientist, I’ve sacrificed animal lives to do so every time I’ve ordered a polyclonal antibody or bottle of FBS. According to radicals like Friedrich that makes me “vivisector”. I’m therefore a monster, like a slaver or murderer.

    This is the unexamined ethics and thoughtless smug moral superiority of the animal rights activist. I doubt, when push came to shove they would sacrifice a human for an animal. Or even a large number of animals. Who, after all, swerves to avoid the squirrel and instead hits the kid on the sidewalk? No one. Human life is more valuable to us because we’re human and that’s OK. It’s not wrong to be self-interested or interested in our survival over that of other species. Survival requires a certain amount of self-interest, human survival requires the ingestion of other living things, and agriculture is never going to be cruelty free.

    The vegan militia have forgotten that to get their cruelty free vegetables, the land has already been cleared, all competing species have been killed or driven out, those that remain are poisoned (even by organic farmers – they just use “certified organic” methods of pest control or even other animals like ladybugs). We put humans first every time we clear a field, dig a foundation, fence and spray our crops, and burn diesel to harvest and bring them to market. We have said, these resources are ours, we own the land, and all the beetles, voles and deer can go right to hell. Survival is cruel, and will always involve putting ourselves before other species.

    The health benefits and technology they enjoy everyday has already been tested and worked out thanks to comparative medicine. It’s easy to feel morally superior about eating greens, and denigrating scientists, now that all that messy stuff has been done and the last time you were on a farm it was to pick a pumpkin in 3rd grade so you don’t know what actually goes into agriculture, even organic agriculture.

    This is not to say I agree with CAFOs, food monoculture, the slimey tactics of Monsanto, or any of the extremes of poor infrastructure, corporate malfeasance and environmental stupidity of our food supply. But lets stop pretending that you become morally superior for eating tofu, all the while you happily ignore the habitat destruction, mass removal of unwanted species, and outright extinctions we’ve caused in order to create our agricultural dominance.

    So let’s stop calling the people who are trying to understand, preserve and extend human lives speciesist (read racist) and vivisectors. Life is complicated. Living it without cruelty to something either requires you to be oblivious to our constant impact on the living things around us, or to retreat into some Jainist agrarian fantasy world that will never exist. Isn’t it better to have a healthy understanding that human beings survive in competition for limited resources with the species around us? We evolved to the point where we’ve become adapt at manipulating and controlling the natural world, and rather than being ashamed of it, we should accept it as a gift from our ancestors after eons of struggle.

  • Supreme Court to Debate Affordable Care Act Next week – and plaintiff's case has imploded

    With the impending, and unprecedented, 3 days of arguments over the Affordable Care Act occurring early next week, it’s interesting to see that the test case being used to challenge the law has now become a test case demonstrating the necessity of the law.

    Mary Brown, the woman who asserts no one has the authority to make her buy health care is now bankrupt, at least in part due to medical bills. From theLA Times article:

    Mary Brown, a 56-year-old Florida woman who owned a small auto repair shop but had no health insurance, became the lead plaintiff challenging President Obama’s healthcare law because she was passionate about the issue.

    Brown “doesn’t have insurance. She doesn’t want to pay for it. And she doesn’t want the government to tell her she has to have it,” said Karen Harned, a lawyer for the National Federation of Independent Business. Brown is a plaintiff in the federation’s case, which the Supreme Court plans to hear later this month.

    But court records reveal that Brown and her husband filed for bankruptcy last fall with $4,500 in unpaid medical bills. Those bills could change Brown from a symbol of proud independence into an example of exactly the problem the healthcare law was intended to address.

    I think at this point the solicitor general just has to point at the plaintiff and say “See! See!”.

    People without health insurance are still covered by the ethical obligations of EMTALA. They can still see doctors and get treatment and not pay their bills. Then who pays for it? All of the rest of us.

    The “individual mandate” should be called a “personal responsibility” provision, because the fact is all these rugged individualists are parasites. They are refusing to pay into the system then benefiting when they, inevitably, need to use it.

    And how about the argument that the commerce clause can’t for such an individual responsibility provision?

    The couple owed $2,140 to Bay Medical Center in Panama City, $610 to Bay Medical Physicians, $835 to an eye doctor in Alabama and $900 to a specialist in Mississippi.

    “This is a very common problem. We cover $30 million in charity and uncompensated care every year,” said Christa Hild, a spokeswoman for the hospital center. “If it’s a bad debt, we have to absorb it.”

    So, this couple has generated bills in three different states that they now will not be able to pay and the rest of us have to eat the bill for them. It’s amazing how the plaintiff’s own actions have justified nearly every argument for the bill. When healthcare now represents something like 1 in 7 dollars spent in this country, how can we argue that the commerce clause does not allow congress to regulate it?

  • 2nd US Hospital to do full face transplant – today at University of Maryland

    The news was just publicly announced that the University of Maryland is now the 2nd hospital to perform full face transplant in the US. Just a handful of these procedures have been performed around the world, and they are enormously complex ethically, surgically and medically.

    To begin with, long before the surgery even became a possibility, there have been years of work put into setting up such a novel transplant program. Besides obtaining approval for what is still an experimental procedure from an IRB, it is necessary to very carefully screen a population of potential recipients. A face transplant is still quite high risk, especially if the surgery fails because it has the potential to cause serious morbidity and mortality. So, patients selected for transplant have to be vetted very carefully. In the case of the first Chinese transplant, the patient stopped taking immunosuppressive drugs in favor of traditional Chinese remedies, and died soon after. This emphasizes the importance of choosing potential recipients that will reliably take their medications as rejection can be catastrophic.

    This surgery took approximately 32 hours from start to finish, and involved a huge multidisciplinary team including multiple transplant and plastic surgeons to perform the procedure. These procedures involve very complex microsurgery to reattach the vascular supply, muscles and nerves to the graft, and, since the jaw and tongue were also transplanted, bones as well.

    The surgery is also just the beginning. A life-long course of immunosuppression is required, at least until we can reliably determine how to induce immune tolerance to transplanted organs (this is an exciting field which has also been in the news). And since the jaw contains marrow, there is a risk of graft versus host disease from the transplanted bone.

    Then there are the complex ethical issues with facial transplant.

    More below the fold…
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  • Transvaginal ultrasound now being legislated in Idaho

    In the continual spread of assaults on women’s reproductive freedom in the wake of the 2010 tea party movement, another state, Idaho, is legislating women receive unnecessary and invasive medical procedures prior to obtaining abortion.

    This is part of an unprecedented effort at the state level to restrict reproductive rights, and in 2011 a record number of these measures have passed.

    And it won’t stop here, as we’ve seen in Georgia, they are trying to pass a law to force women to carry all 20 week gestations to term, even if the fetus is dead. And if you think that’s creepy, Georgia isn’t the first to do it, such laws have succeeded in Nebraska, Idaho, Indiana, Kansas, Oklahoma,Alabama and Utah.

    John Scalzi has a guest post from a physician asking “where’s the outrage?”. Well it’s right here. Scalzi’s poster is suggesting that civil disobedience should follow, but I’m worried that that might be the excuse these states are looking for to shut down clinics and effectively ban all abortion within a state. While I agree the situation is untenable, and is requiring physicians to engage in unethical practice I worry that violating the law is just what the zealots are waiting for. But maybe this needs to happen. We need a test case in front of the courts that asks the question, “can legislatures dictate medical practice in conflict with medical ethics, and without medical justification?” I think the answer would be no, and should be no. Physicians shouldn’t be taking orders from the state on what they do in the examining room. Physician autonomy, ethical practice, reproductive freedoms, and the whole doctor-patient relationship are on the line here. Physicians are here to treat patients, not to serve as tools of the state, against our patients’ interests, to score political points for zealots.

  • Homeschooling needs either tighter regulation or to be banned

    At Alternet there is a great article by Kristin Rawls on homeschooling and educational neglect. I think it makes an excellent argument that homeschooling needs either tighter regulation and oversight, or needs to be outright outlawed:

    In recent weeks, homeschooling has received nationwide attention because of Republican presidential candidate Rick Santorum’s homeschooling family. Though Santorum paints a rosy picture of homeschooling in the United States, and calls attention to the “responsibility” all parents have to take their children’s education into their own hands, he fails to acknowledge the very real potential for educational neglect among some homeschooling families – neglect that has been taking place for decades, and continues to this day.

    Take Vyckie Garrison, an ex-Quiverfull mother of seven who, in 2008, enrolled her six school-age children in public school after 18 years of teaching them at home. Garrison, who started the No Longer Quivering blog, says her near-constant pregnancies – which tended to result either in miscarriages or life-threatening deliveries – took a toll on her body and depleted her energy. She wasn’t able to devote enough time and energy to homeschooling to ensure a quality education for each child. And she says the lack of regulation in Nebraska, where the family lived, “allowed us to get away with some really shoddy homeschooling for a lot of years.”

    “I’ll admit it,” she confesses. “Because I was so overwhelmed with my life… It was a real struggle to do the basics, so it didn’t take long for my kids to fall far behind. One of my daughters could not read at 11 years old.”

    As concerning as the stories of overall educational incompetence of children being raised in the quiverfull movement are, the more serious aspect seems to be the routine discrimination between education of boys and girls:

    Like Garrison, Diegel Martin recounts notable educational gaps in her own family, where there was little academic encouragement. One of her brothers decided to quit school at 16 and faced no parental opposition. The youngest, Diegel Martin says, ceased his formal education at the age of 12, when she left home and was no longer available to teach him herself. And though she was fortunate enough to receive sex education before leaving public school, her siblings were not so lucky. Their parents never taught the three other children about sex, and Diegel Martin remembers giving her 21-year-old sister “the talk” the week before she got married. She also had to intervene to ensure that her younger brothers learned about sex.

    As for herself, when she completed her schooling, she says her parents did not allow her to obtain her GED as proof of high school graduation. Their reason? “The girls weren’t allowed to get a GED because we were told we wouldn’t need it. It would open up opportunities that were forbidden to us. We would work in the family business until we got married, and then become homemakers.

    “When I talked about wanting to go to college, my parents said, ‘Well, you’re a girl. You don’t go to college.’”

    I know I have homeschoolers (and unschoolers) that read this blog and have gotten angry with me being critical of the movement in the past, but there has to be some oversight of homeschooling. Universal primary and secondary education is part of why our country has been so successful, and necessary for the ultimate success of individuals in our society. Children have a right to a decent education that will teach them math, to read, to write, and provide them with basic skills for life. If there is evidence of failure to provide this to children, whether in a public school, private school, or home then for the sake of the children government should intervene. Worse, to educate male children one way and then purposefully provide the girls a poorer education because their destiny is basically to be chattel is horrifying. It strikes me as a violation of their civil rights. For parents to say it’s a matter of religious freedom to deny their children education, or a future outside their home, can not be justified. You don’t have a parental right to deny children a future, or to enslave them.

    Unless a regulatory framework can be designed to incorporate some basic standards into homeschooling, this practice should be outlawed for the sake of these children’s basic civil rights. Surely the homeschoolers who actually believe in educating their children can accept that stories like this are unacceptable, and without data about the performance of homeschoolers, or oversight of homeschooling, this abuse of children’s rights can not be prevented or even detected.

    Via Love Joy Feminism

  • Demanding women deliver dead babies is unethical and unsafe

    In a debate on the floor of the Georgia State house over a bill to force women to bring all pregnancies after 20 weeks to term, even in cases of dead or non-viable fetus, this Georgia representative reaches a new low. State Rep Terry England seems to be suggesting pigs and cows do it, why can’t humans?

    Rep. Terry England compares women to cows, pigs and chickens. from Bryan Long on Vimeo.

    Aside from this genius on-the-farm reasoning of Mr England, the failures of reasoning and misrepresentations of scientific knowledge engaged in to pursue this legislation are many.

    The legislation is justified ostensibly because of the ability of the fetus to feel pain after 20 weeks, but there is no data or a legitimate scientific basis for this claim. Our knowledge of neurological development would suggest that conscious perception of pain may not be possible for a fetus at any point and the neural framework for transmission of pain is not even mature before 29-34 weeks.

    Second is the issue that concern for the pain for a nonviable or dead fetus should not outweigh medical risk to the mother. The American College of Obstetricians and Gynecologists recommend dilation and extraction or induction of labor once the diagnosis of stillbirth has been made. The risks of carrying a non-viable fetus are the higher complication rate of delivery versus dilation and extraction, as well as a very high risk to the mother of complications like disseminated intravascular coagulation (DIC) if the amniotic sac is ruptured and she is exposed to the dying tissue. For stillbirth or nonviable pregnancies, dilation and extraction is far safer and more effective with 24% of patients undergoing labor experiencing complications compared to 3% for D&E.

    It has been under-reported that since the 2010 election, the rate of anti-contraception, anti-abortion, and frankly anti-woman legislation has shot through the roof. In 2011 state legislatures have enacted a record number of laws restricting reproductive rights:

    In the 50 states combined, legislators introduced more than 1,100 reproductive health and rights-related provisions, a sharp increase from the 950 introduced in 2010. By year’s end, 135 of these provisions had been enacted in 36 states, an increase from the 89 enacted in 2010 and the 77 enacted in 2009.

    These include everything from preventing physicians from using telemedicine to prescribe medication to requiring ultrasounds prior to abortion despite the fact no association of OB/Gyns supports universal ultrasound prior to abortion. In an effort to legislate their control of women’s reproductive systems, they are interfering more and more with the physician-patient relationship. It has become so extreme that in 11 states they have legislation requiring physicians to perform unnecessary invasive procedures, basically forcing physicians to engage in unethical medical practices. There is no legitimate medical reason for these measures. These exist to shame women, and increase the expense and difficulty of constitutionally-protected medical procedures and medical decisions like birth control and abortion.

    These efforts to ban abortion after 20 weeks, which have succeeded in several states including Nebraska, Idaho, Indiana, Kansas, Oklahoma,Alabama and Utah, are a highly intrusive attack on women’s reproductive freedom. It is once again, an attempt to insert politics in the doctor-patient relationship. Finally it is medically unethical, dangerous, and morally bankrupt to expose women to greater risk by preventing them from having the option of safe termination of pregnancy all for the sake of a dead fetus.

    Via Jezebel

  • CSPI overblows the cancer risk of caramel coloring in soda

    The safety of soda has been in the news a lot lately. The news even seems bad for diet coke, which hits close to home for me given my diet coke addiction. The worst seems to be this correlative study proposing a link between diet sodas and stroke risk:

    The study, which followed more than 2,500 New Yorkers for nine or more years, found that people who drank diet soda every day had a 61 percent higher risk of vascular events, including stroke and heart attack, than those who completely eschewed the diet drinks, according to researchers who presented their results today at the American Stroke Association’s International Stroke Conference in Los Angeles.

    Disturbing news, however, it’s still just a correlative finding from the Northern Manhattan studyand until things are studied more rigorously, I probably won’t quit my current caffeine source. After all, it can reflect patients who are drinking diet drinks because they are diabetic, a known cardiovascular risk factor not excluded in their analysis.

    Now the Center for Science in the Public Interest (CSPI) has entered the soda fray with a report suggesting the caramel coloring has unacceptably high levels of a carcinogen called 4-methylimidazole.

    An independent study commissioned by the Center for Science in the Public Interest (CSPI) uncovered 4-methylimidazole, or 4-MI, in Coke, Diet Coke, Pepsi and Diet Pepsi at levels 4.8 times greater than those allowed in beverages in California.

    4-MI is a byproduct of the reaction that produces the caramel coloring in brown sodas. The chemical has been found to be carcinogenic in animal studies.

    The state of California has banned 4-MI in any amount that could potentially lead to one cancer case in 100,000 people. However the levels found in these 4 leading Cola brands indicated a lifetime risk of 5 cancers out of 100,000, assuming that people drink one soft drink per day. That risk rises to 10 cancers out of 100,000 people who drink only soft drinks containing caramel coloring.

    .

    But what is the evidence this level of 4-MI could pose a health risk?

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  • Watch James Hansen's TED talk

    I think it’s a nice, succinct description of the problem of climate change from one of the leaders of the field.

    On a related note the nation of Kiribati is relocating to Fiji as their island nation is disappearing.

  • Accountability in Science Journalism: two recent examples of failures in the NYT and Forbes

    ResearchBlogging.orgEd Yong demands higher accountability in science journalism and has made me think of how in the last two days I’ve run across two examples of shoddy reporting. These two articles I think encompass a large part of the problem, the first from the NYT, represents the common failure of science reporters to be critical of correlative results. While lacking egregious factual errors, in accepting the authors’ conclusions without vetting the results of the actual paper, the journalist has created a misleading article. The second, from Forbes, represents the worst kind of corporate news hackery, and shows the pathetic gullibility of reporters regurgitating the fanciful nonsense of drug companies without any apparent attempt to vet or fact-check their story. With a google search the facts are smashed.

    The first article Digital records may not cut costs, I think is typical of most science reporting. That is, it’s not grossly incompetent but it overstates the case of the article involved and fails to amplify the shortcomings of the research.

    The NYT article is describing this article from Health Affairs, which caught my eye before the NYT article was even published because I believe electronic medical records (EMRs) will prevent redundancies and lower costs. So, am I wrong? Will EMRs save us money or possibly increase redundancy as the HA article suggests?

    I haven’t given up hope. This article is a correlative study based on survey data, and proves precisely nothing.

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  • What is the cause of excess costs in US healthcare? Take two

    We’ve discussed it before, why are costs so much higher in US healthcare compared to other countries? The Washington Post has a pointless article which seems to answer with the tautology costs are high because healthcare in America costs more. How much more? Well, we spend nearly twice as much per capita as the next nearest country while failing to provide universal coverage:

    i-880005398336c472547ab02e425e6cd0-commonwealthfigureII8.jpg

    In the WaPo article they make a big deal of the costs of individual procedures like MRI being over a thousand in the US compared to $280 in France, but this is a simplistic analysis, and I think it misses the point as most authors do when discussing this issue. The reason things costs more is because in order to subsidize the hidden costs of medical care, providers charge more for imaging and procedures. For instance, Atul Gawande, in his New Yorker piece “The Cost Conundrum” wonders why is it costs are higher to treat the same conditions in rural areas and in a major academic centers like UCLA than at a highly specialized private hospitals like the Mayo Clinic? I think the reason is it’s not nearly as expensive to administer and provide care for a select group of insured midwesterners at the Mayo than it is to provide care to the underserved in the poor areas of inner-cities and in poor rural locations.

    When you are serving a poorer, under-insured population like you get in LA or Baltimore for that matter, the insured are charged more because EMTALA requires hospitals to treat all comers, regardless of insured status. Medical centers like UCLA or University of Maryland are the final common pathway for the sickest and poorest patients who, even if stabilized at smaller local hospitals, are immediately transferred to such centers. These patients are expensive to treat, often have more co-morbidities like HIV or drug use and mental illness, and there is no reimbursement guarantee for taking care of them even though it is our legal and ethical responsibility to do so.

    Further, the cost of defensive medicine, which applies to this patient population as much as any other, ramps the costs of all hospital admissions and medical practice in general. It is also incredibly hard to quantify its contribution to the overall costs of care.

    As a result, to pay for excessive care of the uninsured, all procedures, all tests, all imaging, and all hospitalizations cost more. Caring for inpatients and the uninsured is expensive, so the costs are transferred to the prices of outpatient elective care and procedures which are often administered in a fee-for-service model. Hospitals have an incentive to provide as much outpatient elective care as possible in order to offset these other costs and to generate revenue. The providers that perform procedures or expensive testing then become far more expensive to pay as they are the major revenue generators for the hospital (hence surgeon vs pediatrician pay). Especially because in order to generate more revenue they are paid based on how many procedures they perform. All the incentives are towards more utilization, more procedures, more revenue generation. This is the hidden tax of the uninsured.

    In a way, we have universal healthcare already, but we pay for it in the most irresponsible and costly way possible. We wait for small problems to become emergent, treat them in the most expensive outpatient provider possible (the ER), and then when we can’t pay the bills for the uninsured, we transfer the balance by increasing the costs of the care of insured patients showing up for their cholecystectomies or back surgery. Tack on the costs of defensive medicine and the fear of being sued unless everything is done to cover your ass, and you have a recipe for extremely costly care.

    Other factors figure into higher costs as well, including hugely higher costs of medicare administration since Bush privatized it, higher prescription drug costs since Bush passed medicare part D and prevented bargaining with drug companies, and our incredibly high ICU expenditures at the end of life. the McKinsey report on excess costs demonstrated most of these issues in 2008. This is not news. The US spends far more on medical administration, outpatient/ambulatory care (with hospital-based outpatient care increasing most rapidly in costs), drugs, doctors salaries, and end-of-life care than we should as a percentage of our GDP.

    So what should we do about it? At every step we need dismantle the tendency towards increasing costs. Here are my suggestions:
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