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Two days ago, I mentioned Frances Kissling's proposal to reward organ donors by offering them "comprehensive long-term health insurance" as well as "life and disability insurance." Kissling framed the offer not as an incentive but as "the basic safety net that a just and giving society should provide people who offer to risk their own lives to save the lives of others."
She's not alone. Singapore has just "passed a law allowing cash payments to organ donors," according to Agence France Presse. "Previously, it was illegal for a living donor to be financially compensated." But now "an organ recipient can voluntarily pay the donor if he wishes to help cover expenses like hospital and surgery fees."
And how did proponents of the legislation present it? "This is a bill about fairness, being fair to donors who do suffer financial consequences as a result of their act of donation," Singapore's health minister told parliament during the debate. "I know the controversial nature of paying donors. But we also realize that it is unfair to allow genuine donors to bear all the financial consequences of their altruistic acts."
Coverage of transplant-related medical expenses is already legal in the United States. But it'll be interesting to see whether the message from Singapore—fairness to altruists—becomes an effective argument, here and elsewhere, for more extensive compensation.
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If you put your kid on ADHD drugs, what will you have to show for it three years later?
Maybe just a smaller kid.
Shankar Vedantam outlines the unpleasant findings in the Washington Post:
New data from a large federal study have reignited a debate over the effectiveness of long-term drug treatment of children with hyperactivity or attention-deficit disorder, and have drawn accusations that some members of the research team have sought to play down evidence that medications do little good beyond 24 months. The study also indicated that long-term use of the drugs can stunt children's growth.
In the early stages of the project, known as the Multimodal Treatment Study of Children With ADHD, the drugs looked good. But as years went by, the benefits faded, and the only remaining effect was, in relative terms, physical shrinkage:
In August 2007, the MTA researchers reported the first follow-up data, which by then no longer showed differences in behavior between children who were medicated and those who were not. But the data did show that children who took the drugs for 36 months were about an inch shorter and six pounds lighter than those who did not.
Here's the report published by the study's supervisors in 2007:
The newly medicated subgroup showed decreases in relative size that reached asymptotes by the 36-month assessment, when this group showed average growth of 2.0 cm and 2.7 kg less than the not medicated subgroup, which showed slight increases in relative size.
Conclusions: Stimulant-naive school-age children with Combined type attention-deficit/hyperactivity disorder ... show stimulant-related decreases in growth rates after initiation of treatment, which appeared to reach asymptotes within 3 years without evidence of growth rebound.
Without evidence of growth rebound. You lose two centimeters of expected growth—more than three-quarters of an inch—and you don't get them back. That's nowhere close to the two feet of height you can withhold from a prepubescent girl through estrogen therapy. But it's just as permanent.
And how did the study's funder, the National Institute of Mental Health, spin the bad news? Vedantam tweaks the Institute for its truth-stretching headline—"Improvement Following ADHD Treatment Sustained in Most Children"—and for euphemistically reporting that kids who weren't drugged "grew somewhat larger."
This study won't settle the debate over ADHD drugs. But it should sober anyone who thinks that medicating the mind won't affect the body—or that the effects can be erased.
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Is it OK to guess a perpetrator's race and appearance from DNA found at the crime scene?
A few weeks ago, Gautam Naik of the Wall Street Journal updated us on a fertility clinic's program to screen embryos for "eye color, hair color and complexion." The clinic hoped to use a method that could supposedly "identify [genes] that relate to northern European skin, hair and eye pigmentation in 80%" of IVF embryos.
Two weeks later, when the clinic suspended the program, I suspected its concession was more technical than moral. Predicting traits from genes is hard. That's one reason why so many threats and promises of genetic engineering haven't materialized.
But now it seems I may have underestimated the field. Naik has returned with further research on the genetics of appearance. Gene-trait correlations are becoming increasingly precise. And the practice to which they're being applied most aggressively isn't embryo screening. It's law enforcement.
Here's his latest report:
Murray Brilliant, a geneticist at the University of Arizona, is developing a predictive test for skin, eye and hair color. Supported by a grant from the U.S. Department of Justice, he and his colleagues recently analyzed DNA material provided by 1,000 university students from different ethnic backgrounds. They found a total of five genes that account for 76% of the variation for hair color, 75% for eye color and 46% for skin color. Similarly, scientists from Erasmus University published a paper in March in the journal Current Biology based on a DNA analysis of 6,000 people in the Netherlands. For that population group, they found that only six DNA markers are needed to predict brown eye color with 93% accuracy and blue eye color with 91% accuracy.
Some of those numbers are quite impressive. If they're packaged into an affordable embryo test, I guarantee you buyers will start lining up. But look where the money's coming from. Brilliant got his grant from DoJ. The Erasmus group got its funding from the Netherlands Forensic Institute, which "provides services to clients within the criminal justice chain, such as the Public Prosecution Service and the police." In fact, Naik points out, "[t]he push to predict physical features from genetic material," known as "DNA forensic phenotyping," has
already helped crack some difficult investigations. In 2004, police caught a Louisiana serial killer who eyewitnesses had suggested was white, but whose crime-scene DNA suggested—correctly—that he was black. Britain's forensic service uses a similar "ethnic inference" test to trace murderers and rapists. In 2007, a DNA test based on 34 genetic biomarkers ... indicated that one of the suspects associated with the Madrid bombings was of North African origin.
Whoa, there. Do we really want cops hunting for people of a particular race or ethnicity based on uncertain inferences from a DNA sample? Apparently several states don't. Nor does Germany. These jurisdictions, according to Naik, forbid "the forensic use of DNA to infer ethnicity or physical traits."
I understand the concern. But these prohibitions are a mistake. DNA forensic phenotyping doesn't need to be perfect. It just needs to be better than—or a substantial way of double-checking—the unscientific inferences we already make.
The Louisiana case sets off racism alarms because DNA phenotyping said the culprit was black, whereas witnesses said he was white. But that isn't the usual pattern. Decades of research suggest that a witness is more likely to misidentify a person as the perpetrator when the accused person is of a different race. And according to the Innocence Project,
Racism continues to be a significant cause of wrongful convictions. While 29% of people in prison for rape are black, 64% of the people who were wrongfully convicted of rape (and then exonerated through DNA) are black. Moreover, most sexual assaults nationwide are among perpetrators and victims of the same race (the federal government says just 12% of sexual assaults are cross racial), but two-thirds of all black men exonerated through DNA evidence were wrongfully convicted of raping white people.
DNA phenotyping didn't invent the problem of erroneous racial inferences in law enforcement. That problem is as old as racism and lives on through mug books, lineups, and eyewitness testimony. As the Innocence Project points out, DNA is beginning to clean up the problem. Granted, DNA phenotyping isn't nearly as reliable as DNA matching. But is it really worse than relying on witnesses alone? At the very least, wouldn't it be useful and wise to check witness recollections of the perpetrator's race or ethnicity against a DNA phenotype analysis?
The same goes for facial features. Naik reports:
Mark Shriver, an anthropologist and geneticist ... [is] trying to construct a "picture" of a person's face by analyzing DNA. He calls the technique "forensic molecular photo fitting," and it is supported by a $500,000 grant from the U.S. Department of Justice. ... His team collected DNA samples and photographs from 243 people ... and used computer techniques to correlate the genes with his subjects' facial features. They have found six genes that seem to influence such traits. One gene is associated with the height of the face; another is associated with its width. Yet another gene affects the shape of the lips and the nose. By piecing together these elements, Prof. Shriver hopes to create a modern-day version of the police artist sketch.
Initial results of this method will probably be pretty crude. But will it end up being worse than old-fashioned police sketches based on eyewitness accounts? Would we have caught the Son of Sam killer earlier, for instance, if his police sketch hadn't been wildly inaccurate, making him look Latino or Asian?
No, DNA phenotyping isn't perfect. But it's better than nothing. And it's better than trusting witnesses alone.
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If financial incentives for donating a kidney are wrong, what about financial rewards?
Frances Kissling offers that idea in a beautiful piece at Salon. She writes:
Appropriate concern for the international organ trafficking problem ... has so distorted the concept of altruism and eroded the principle of mutual respect that potential kidney donors are denied the basic safety net that a just and giving society should provide people who offer to risk their own lives to save the lives of others. ... [W]e financially abandon the donor almost immediately after we take their kidney. There is no provision for comprehensive long-term health insurance for donors, or for life and disability insurance. Opponents of any form of compensation or benefit to donors beyond costs directly attributable to the transplant itself fight efforts to provide these benefits.
What worries compensation opponents is that such benefits, framed as incentives to increase the organ supply, will economically coerce poor people to surrender body parts. But what if we don't frame the benefits as incentives? What if we present them, in Kissling's words, as what "a just and giving society should provide [to] people who offer to risk their own lives to save the lives of others"? And could we make this difference real, not just a matter of spin, by designing the reward system without regard to its effect on the organ supply?
Kissling argues that we should
treat potential donors with the same generous spirit with which they have offered their kidneys. No donor should spend a single dollar in the process of giving an organ. And donors should have the safety net they need to stay healthy, to support their family if they cannot work and life insurance should they die. ... One member of Congress who gets it is Arlen Specter, who is circulating the Organ Trafficking Prohibition Act of 2009. The bill increases the penalties for really buying and selling organs, but makes clear that state and federal government can provide the kind of benefits donors deserve without going to jail. Anyone disagree?
Well? Do you?
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It's a tough time to be a mayor or governor. Budgets are tight, tax hikes are unpopular, and you can't easily hire cops and parking enforcement officers to hand out more tickets. Fortunately, there's a way to increase citations and revenue without adding to your payroll: traffic cameras.
William Bulkeley documents the trend in the Wall Street Journal:
Suppliers estimate that there are now slightly over 3,000 red-light and speed cameras in operation in the U.S., up from about 2,500 a year ago. The Insurance Institute for Highway Safety says that at the end of last year, 345 U.S. jurisdictions were using red-light cameras, up from 243 in 2007 and 155 in 2006. One traffic-cam seller, Arizona-based American Traffic Solutions Inc., recently reported it had installed its 1,000th camera, with 500 more under contract in 140 cities and towns. Rival Redflex Holdings Ltd. says it had 1,494 cameras in operation in 21 states at the end of 2008, and expects to top 1,700 by the end of this year.
Cities say they're putting up these cameras to protect the public. But the Journal points out that this effect isn't clear:
Some research indicates they may increase rear-end collisions as drivers slam on their brakes when they see posted camera notices. A 2005 Federal Highway Administration study of six cities' red-light cameras concluded there was a "modest" economic benefit because a reduction in side crashes due to less red-light running offset the higher costs of more rear-end crashes.
If the safety rationale isn't compelling, what's behind the camera trend? Look at the first case Bulkeley cites:
The village of Schaumburg, Ill., installed a camera at Woodfield Mall last November to film cars that were running red lights, then used the footage to issue citations. Results were astonishing. The town issued $1 million in fines in just three months.
And what did the camera do for safety? It "mainly snared those who didn't come to a full stop before turning right on red," Bulkeley reports. Not exactly a vital public service, except for the money.
Elsewhere, the financial rationale is explicit. "Last June, Arizona added a provision for speed cams on highways to its budget bill, with an anticipated $90 million in fines expected to help balance the budget," Bulkeley notes. And get this:
[A] study in last month's Journal of Law and Economics concluded that, as many motorists have long suspected, "governments use traffic tickets as a means of generating revenue." The authors ... studied 14 years of traffic-ticket data from 96 counties in North Carolina. They found that when local-government revenue declines, police issue more tickets in the following year.
Oh, and one more thing: The cameras "are operated by for-profit companies that typically make around $5,000 per camera each month." It's a surveillance-industrial complex.
I can't claim to be impartial on this subject. In the last few years, I've paid around $400 for tickets issued by traffic cameras—way more than I've paid for tickets issued by human officers. Most of that total came from three tickets issued by the same camera for the same infraction in a two-week period. If a human officer had ticketed me the first time, my wife and I would have realized we'd broken the law, wised up, and driven that stretch of road more carefully. Instead, the traffic camera quietly collected photos, and the government didn't send us any tickets—which is what finally alerted us to the violations—until we'd repeated the mistake three times.
I'm not proud of breaking the law. But I'm not stupid, either. By using inconspicuous surveillance and delaying notification, the government traded public safety for revenue.
Big Brother is watching you. And when he needs cash, he watches that much more closely.
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The most interesting moment in President Obama's Tuesday night press conference is something you won't pick up from the transcript. You have to watch the video. Forty-six minutes in, John Ward of the Washington Times asks Obama about stem cells. Obama replies:
[I]t is very important for us to have strong moral guidelines, ethical guidelines, when it comes to stem cell research or anything that touches on, you know, the issues of possible cloning or issues related to, you know, the human life sciences. I think those issues are all critical, and I've said so before. I wrestle with it on stem cell; I wrestle with it on issues like abortion.
What the transcript doesn't convey is that after saying "anything that touches on," it takes Obama a full 15 seconds of stumbling, stalling, and groping before he finds the phrase "human life sciences."
Obama, unlike President Bush, knows his way around the English language. He doesn't stumble, stall, or grope for lack of words. He does it because he was about to say something but decided not to say it. The giveaway here is that he eventually settles on the phrase "human life sciences," which I've never heard before from a politician. Supporters of embryonic stem-cell research talk about "life sciences." Opponents talk about "human life." Neither side likes to focus on the other's magic word: human for pro-lifers or sciences for research proponents.
I think Obama settled on "human life sciences" because he was originally going to say "anything that touches on human life." And he decided at the last minute that he'd better not say that, because that would buy into the other side's framing of the issue and get him into trouble. The human-life frame, planted by Ward, was clearly in Obama's head, as evidenced by his next sentence: "I wrestle with it on stem cell; I wrestle with it on issues like abortion." But strategically, you're not supposed to accept the other side's frame. Once you group stem-cell research with abortion, you're giving away the fight. You're supposed to group stem-cell research with the Bush administration's deceptions about abstinence and global warming. It's all part of the "Republican war on science." So, after his 15 seconds of groping, Obama splits the difference and comes up with the phrase "human life sciences."
We saw the same thing two weeks ago, when Obama lifted the ban on federal funding of stem-cell research using destroyed human embryos. Most research proponents, including his own aides, stuck to the "science" message and didn't mention moral objections. But Obama did mention them. His remarks sounded a lot like what he has said about abortion and other social issues: acknowledging moral disagreement while striving for consensus or at least compromise.
On Tuesday, after Obama's initial answer, Ward asked a follow-up: "Do you think that scientific consensus is enough to tell us what we can and cannot do?" Obama replied: "No. I think there's—there's always an ethical and a moral element that has to be—be a part of this."
Obama, like the rest of us, is grappling with how to think about biotechnology. We're all familiar with social, financial, public-safety, and health-care issues. But this is a new kind of issue: It's moral, economic, and life-and-death. To some of us, it's about life sciences. To others, it's about embryonic human life. It took Obama 15 seconds to put the two perspectives together in words. If it takes him eight years to put them together in practice, that'll be one hell of an achievement.
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Big news from Pakistan: The government there is becoming a partner in our remote-controlled assassination campaign. Here's the deal: They'll let us kill our enemies on their soil if we'll use the same drones to kill their enemies, too.
Officially, Pakistan continues to object to the drone strikes. We just hit two more targets yesterday, prompting Pakistan's Foreign Office to declare that "these attacks are counterproductive and we hope that as a result of the policy review in Washington, we would have some positive outcome."
That's a pretty funny protest, since today's Wall Street Journal brings this news:
U.S. and Pakistani intelligence officials are drawing up a fresh list of terrorist targets for Predator drone strikes along the Pakistan-Afghanistan border, part of a U.S. review of the drone program, according to officials involved. Pakistani officials are seeking to broaden the scope of the program to target extremists who have carried out attacks against Pakistanis, a move they say could win domestic support. ...
Already, the campaign has apparently stepped up attacks on the network of Pakistani Taliban leader Baitullah Mehsud, who is believed to be behind the 2007 assassination of former Prime Minister Benazir Bhutto, who was [current President] Zardari's wife. In the fourth of a series of recent attacks targeting Mr. Mehsud's network, a drone attack Wednesday killed at least eight militants along the Pakistan-Afghan border, according to two Pakistani officials. The intensified campaign could help win domestic support for the strikes because it shows that the drone attacks are targeting direct threats to Pakistan, said a Pakistani official.
To put it crudely, we seem to be renting out the drones. Since President Obama took office, the drones have been slaughtering Mehsud's fighters. Apparently, we're doing this to satisfy Zardari's government. And it's not clear whether the satisfaction is political or personal. Do the hits on Mehsud really generate "domestic support" for the drone strikes? Does the average Pakistani conclude that the CIA's killing machines aren't so bad after all? Or does the "domestic support" consist of Zardari? Are we buying his support by sending our drones to avenge his wife's death?
It's almost Shakespearean. But since we're in the 21st century instead of the 16th, we seal our pact with the king by sending machines, not human assassins, to bring heaven's wrath on the warlord who slew his beloved. And this time, the wrath really does come from heaven. Put yourself in Zardari's shoes. You're being offered the chance to destroy your enemy with a power unknown to history's greatest kings and generals: a bloodless, all-seeing airborne hunting party. Would you refuse?
And if you were Obama, would you refuse to wield this power? No way. According to the Journal, Obama has "concluded that the drones have been an effective weapon," and his aides are now "examining ways to reduce the time it takes between identifying a target and when the Predators fire—now less than 45 minutes." And in a curious coincidence, the U.S. also just announced a $5 million reward for "information leading to the arrest or location of Mehsud" and another warlord.
Something tells me there won't be an arrest. Location will be enough.
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Yesterday I wrote about an awful story in California. A number of couples hired gestational surrogates through a fertility brokerage. They were directed to put money in trust accounts to pay the surrogates throughout their pregnancies. Now the money is gone. Andy Vorzimer, an attorney involved in the case, told the New York Times, "We've got couples in the midst of pregnancies with no ability to pay the surrogate." I ended the piece this way:
I hope the women carrying these pregnancies will see them through, even if the company that hired them doesn't. But that financial burden shouldn't fall on them alone. Here's the contact page for an attorney working the case. If you'd like to prevent abortions, help pregnant women, and facilitate reproductive choice at the same time, now's your chance.
Yesterday evening, Vorzimer sent me an e-mail to clarify the situation:
The article has obviously resonated with your readers as my inbox has been flooded with concerned people offering to donate funds so as to avoid possible abortions. I am happy to inform you that there are no situations in which a surrogate has elected to abort because of this financial scandal. While many of the surrogates will not be reimbursed for their out-of-pocket expenses lost wages or even have their medical bills paid, every single one of them has committed to moving forward.
That's great news. I'm impressed with the surrogates. I'm also impressed with all of you who contacted Vorzimer and offered your support so they wouldn't have to end their pregnancies. Pro-lifers are often accused of moralizing and interfering but not helping. You disproved the caricature. And I hope you'll stand by your offers even if no abortions are at stake.
In recent days, I've had a few curious exchanges with friends, readers, and bloggers who wonder why I keep writing about this stuff: abortions, pregnancies, IVF, surrogates—what some of my critics jokingly call "lady parts." What's my agenda? Do I have a problem with women controlling their bodies? Am I a frontman for the religious right, a useful idiot who pretends that compromise on these issues is possible when, in fact, it isn't? Even Vorzimer, in a tweet posted on his blog, initially responded to my article by remarking, "The lengths (or depths) abortion foes will go to make a point."
Vorzimer and I have had some back and forth since then, so we've come to understand each other better. But the misunderstanding was my fault, not his. I need to do a better job of explaining myself.
This may sound strange, but I don't consider myself a real abortion foe. I have friends and sparring partners who think abortions should be illegal or at least heavily restricted. To me, that's the chief dividing line in the debate. I don't feel comfortable crossing that line. I don't think a regime of abortion restrictions enacted in the name of life would make this world a better place. I think it would cause a mess—hypocrisy, deceit, interrogations, amateur home surgery, moral crudity backed by the force of law—as ugly as any war fought in the name of peace.
I don't equate abortion with murder. I don't even think it's the worst option available to a woman facing unintended pregnancy. Every abortion dilemma is different, because every situation is different. The person best situated to make the right decision is the pregnant woman. A few years ago, I wrote a whole book on this point.
So why do I keep bringing up abortion as a moral problem? Because it is a moral problem. It's the destruction of a developing human being. For that reason, the less we do it, the better. When I say abortion is bad, I'm not saying it's necessarily worse than bringing a child into the world in lousy circumstances. I'm saying it's worse than avoiding unintended pregnancy in the first place. That's why I keep pushing contraception. If you cause an unintended pregnancy and an abortion because you didn't want to wear a condom, you should be ashamed.
But that's the conventional life/choice debate. The reason I keep you posted on developments in IVF, surrogates, and embryo screening is that they're transforming the debate. They're changing the conditions on which our moral positions rely. Were you pro-choice because the embryo was in a woman? Now we have embryos in dishes. Did you support embryo screening for fatal diseases? Now we're talking about screening embryos for eye color. Does the value of an embryo depend on what its mother thinks? Now we have embryos with two mothers: a genetic one and a gestational one. Should they at least consult each other?
I got into this field because the moral questions are enduring but the facts are always changing. Technology is transforming culture. And I write about the value of unborn life because that's the problem my fellow pro-choicers don't like to talk about. I want to challenge you. Keeping the government out of these sticky moral questions doesn't make them go away. It just puts the burden on you to face them responsibly.
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What if you delivered the money to a broker, and the broker lost, stole, or squandered it? You did your part, but the surrogate is no longer being paid. And she has every legal right to end the pregnancy.
That's the scenario unfolding in California.
More here.
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From time to time, Human Nature checks in on the man-vs.-machine war experiment that's going on halfway around the world in Pakistan. It's like a video game, except real people are being killed. Al-Qaida and the Taliban are fielding human fighters. The United States is fielding remote-controlled unmanned aircraft armed with missiles. American generals and defense planners are watching this war to find out how much an unmanned force can accomplish. The less blood we have to risk and shed, particularly against an enemy who thrives on body bags and terror, the safer we'll be at home and abroad.
So, who's winning: the jihadis or the joysticks? Greg Miller of the Los Angeles Times brings us a fresh update. Here's an analysis of his report and other stories filed in the last week, explaining the most important developments and why they matter.
1. How many strikes and kills? Since Aug. 31, there have been 38 Predator strikes, killing 9 "senior" al-Qaida leaders and many lower-level fighters. And that's not counting conventional airstrikes based on hot intelligence from the drones.
2. Why the increase? We stopped asking Pakistan for permission before striking. This has three effects: Strikes don't get vetoed, they don't get delayed till the intelligence (e.g., about who's in the compound) is cold, and the targets don't get tipped off by friends in the Pakistani government.
3. Where do the drones fly from? This has been a politically explosive question lately. Miller says the CIA Predators "take off and land at military airstrips in Pakistan."
4. Can they see through walls? Not literally, but in effect, yes. They're "outfitted with additional intelligence gear that has enabled the CIA to confirm the identities of targets even when they are inside buildings and can't be seen through the Predator's lens." If true, this is a huge development. It means the men have nowhere to hide from the machines.
5. Do the joystick pilots understand real combat? I've raised this question before, on the theory that killing real people from a faraway drone console can look too much like a video game. The CIA is mum about its people. But Christopher Drew of the New York Times reports that the Air Force "has begun training officers as drone pilots who have had little or no experience flying conventional planes."
6. Why is Pakistan tolerating the strikes? "Because the CIA has expanded its targeting to include militant groups that threaten the government," Miller reports. To that extent, the machines have become Pakistan's allies. If true, this is another big development. The Pakistan war experiment isn't just technological. It's political. It's a test of whether the drones can inflict military damage without triggering too much anti-Americanism. By buying off the host government with hits on its enemies, we're buying time to keep hitting our own enemies there. Politically, it's hard to imagine a manned U.S. force getting away with what the drones have done.
7. What are the drones' psychological effects? Among other things, the Pakistan experiment is testing how a war waged by machines affects the morale of their human adversaries. U.S. officials tell Miller that the militants, hounded and pounded by the drones, "have begun turning violently on one another out of confusion and distrust." One official says that al-Qaida operatives are "wondering who's next," that they're "hunting down people who they think are responsible" for exposing them to the drones, and that "people are showing up dead or disappearing." Mark Mazzetti of the New York Times adds that in northwest Pakistan, "[s]ome locals have given up drinking Lipton tea, out of a growing conviction that the [CIA] is using the tea bags as homing beacons for its pilotless planes."
On the other hand, Mazzetti reports many Pakistanis think that the drones "reveal the fears of Americans to take casualties"—that we're "sending robots to do a man's job." He cites P.W. Singer's book Wired for War, in which Muslim insurgents "said that America's reliance on drone weapons is a sign that the United States is afraid to sacrifice troops in combat."
I'm not buying this. I'm not buying the U.S. spin that the drones are reducing al-Qaida to fratricide. And I'm sure not buying this jihadi propaganda about the glory of sacrifice. Sacrifice is for suckers. Even terrorists know that. That's why, as Drew reports, our ostensibly cowardly drone operators are watching this:
On a recent day, at 1:15 p.m. in Tucson—1:15 the next morning in Afghanistan—a pilot and sensor operator were staring at gray-toned video from the Predator's infrared camera. ... The crew was scanning a road, looking for ... signs of anyone planting improvised explosive devices or lying in wait for a convoy. ... "We spend 70 to 80 percent of our time doing this, just scanning roads," said the pilot. ...
In short, our people are hiding behind lethal gizmos watching your people plant lethal gizmos and hide. Your people don't intend to be there when the bombs go off any more than ours do. So if we're sissies, so are you.
8. Obama's plans? "Because of its success, the Obama administration is set to continue the accelerated campaign," Miller reports. The New York Times' David Singer and Eric Schmitt add that Obama is thinking of extending the strikes deeper into Pakistan:
The extensive missile strikes being carried out by [CIA]-operated drones have until now been limited to the tribal areas. ... But some American officials say the missile strikes in the tribal areas have forced some leaders of the Taliban and Al Qaeda to flee south toward Quetta, making them more vulnerable. In separate reports, groups led by both Gen. David H. Petraeus, commander of American forces in the region, and Lt. Gen. Douglas E. Lute, a top White House official on Afghanistan, have recommended expanding American operations outside the tribal areas if Pakistan cannot root out the strengthening insurgency.
Broadening the war in Pakistan is hugely dangerous. But if we do it, the safest force to send in isn't the Marines, Green Berets, or stealth fighters. It's the drones.
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Two days ago, we were talking about how the physical and digital worlds are beginning to converge and blur.
Step 1: physical hyperlinks.
Step 2: the integration of physical perception with 3-D digital maps.
Step 3? I speculated that it might be a change in human perception through external devices, biotechnology, or acculturation. But maybe that's Step 4. Maybe Step 3 is the convergence of the phone with the universal remote.
There's nothing mind-blowing about this idea. But that's the point. In real life, cosmic revolutions unfold incrementally: a device here, a software upgrade there. The New York Times lays out some of the new options:
1. A free application (called Remote) and a gizmo (called Intelliphone) that enable iPhones to control computers.
2. A $100 hardware-software package (called Shadow) that "converts a BlackBerry's Bluetooth transmission into an infrared signal your TV can understand." A similar device lets the BlackBerry control a garage door.
3. A $10 app (called i-Clickr) that uses the iPhone screen to display buttons that will operate a PowerPoint presentation on a nearby PC.
The Times says this is "probably the beginning of the end" for the universal remote, since it relies on buttons, whereas a smartphone screen can provide as many options as you need. But my guess is that a more fundamental dynamic is at work: We want to centralize our power to manipulate the things around us. The universal remote was supposed to do that. But it doesn't, because it can't navigate the digital world the way the smartphone can.
We need to consolidate these two devices. And it's a lot easier to put the remote's abilities in the smartphone than vice versa.
Bye-bye, universal remote. You can't be universal when you don't reach the other universe.
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Remember that bill in Georgia to restrict in vitro fertilization? The Associated Press thought it was dead. Surprise! The Georgia Senate revised it and passed it a week ago.
The bill is part of a nationwide project to regulate the emerging industry of embryo production. In one state or another—and then another and another—legislation will be filed to restrict IVF. The battles will be fought over which uses of preimplantation genetic diagnosis are acceptable. And these fights will be every bit as ugly as the preceding fights over abortion.
More here.
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How do alternate universes materialize, coexist, and converge? Here's one answer: Look at your cell phone.
Two years ago, I saw an article in the New York Times about "physical hyperlinks." Essentially, these are contact nodes between the physical and digital worlds. I can hardly begin to explain them. So I'll let the Times' Louise Story do the talking:
New technology, already in use in parts of Asia but still in development in the United States, allows [cell] phones to connect everyday objects with the Internet. In their new incarnation, cellphones become a sort of digital remote control, as one CBS executive put it. With a wave, the phone can read encoded information on everyday objects and translate that into videos, pictures or text files on its screen. ...
In Japan, McDonald's customers can already point their cellphones at the wrapping on their hamburgers and get nutrition information on their screens. Users there can also point their phones at magazine ads to receive insurance quotes, and board airplanes using their phones rather than paper tickets. And film promoters can send their movie trailers from billboards. ...
"You've picked up this product, and you don't want to go back to your PC," said Tim Kindberg, a senior researcher at the Bristol, England, lab of Hewlett-Packard. "Or you're outside this building, and you want more information. We call it the ‘physical hyperlink.' "
In much the same way that Web publishing took off because of the ability to link to other people's sites, cellphone technologies linking everyday objects with the Web would reveal the digitally encoded attributes of tangible things on grocery shelves or newsstands.
In this rendering of the nexus between space and cyberspace, the cell phone is the reader. It translates physical objects into their digital incarnations. The operative digital incarnation, as of 2007, was bar codes:
The most promising way to link cellphones with physical objects is a new generation of bar codes: square-shaped mosaics of black and white boxes that can hold much more information than traditional bar codes. The cameras on cellphones scan the codes, and then the codes are translated into videos, music or text on the phone screens. ... Now, as more cellphones come equipped with cameras and the ability to run small computer programs, the codes are beginning to appear on some state drivers' licenses and on some mailing labels ... In Japan, some highway billboards have codes large enough for passing motorists to read them with their phones. Hospitals put them on prescriptions, allowing pharmacies to instantly scan the medical information rather than read it.
So, in a way: cell phone + bar code = wormhole.
That was two years ago. I've been waiting for the next piece of the puzzle. I think this is it: the integration of physical perception with three-dimensional digital maps. Here's the Times' John Markoff:
Digital map displays on hand-held phones can now show the nearest gas station or A.T.M., reviews of nearby restaurants posted online by diners, or the location of friends. ... Indeed, a new generation of smartphones like the G1, with Android software developed by Google, and a range of Japanese phones now "augment" reality by painting a map over a phone-screen image of the user's surroundings produced by the phone's camera. With this sort of map it is possible to see a three-dimensional view of one's surroundings, including the annotated distance to objects that may be obscured by buildings in the foreground. For starters, map-based cellphones simply translate paper maps into a digital medium, but future systems will probably begin to blur the boundaries between the display and the real world. ...
Steve Capps, one of the designers of the original Macintosh interface, [asks], "How long will it be before you come out of the subway and you hold up your screen to get a better view of what you're looking at in the physical world?"
Increasingly, phones will allow users to look at an image of what is around them. You could be surrounded by skyscrapers but have an immediate reference map showing your destination and features of the landscape, along with your progress in real time.
If I understand this transition correctly, we're no longer talking about two worlds, one physical and one digital, connected at selectively engineered nodes. We're now talking about a wholesale overlap between the two worlds. Every physical object, or at least every object of sufficient size to be mapped, will have a digital incarnation. And you'll be able to alternate smoothly between the two worlds, most conspicuously by using your 3-D digital map to see right through a visual obstruction.
This is how cosmic revolutions unfold in real life: not abruptly or mysteriously, as in science fiction, but incrementally. A device here, a software upgrade there, a synchronization, a multiplication. New technologies, new possibilities, new combinations, new habits. Economics and culture are as crucial to this process as technical innovation.
The next piece of the puzzle may not be a change in either of the two worlds. It may be a change in what is, for now, the ultimate reader: the human being. This could take place through externally worn devices, biotechnology, or acculturation. But one way or another, we'll begin to shift our mental attention and our comfort zone from the physical to the digitally enhanced environment. If you want to see what this kind of mental migration looks like, just glance at all the people around you who are talking on cell phones, lost in invisible worlds, oblivious to their surroundings.
If we're lucky, the next migration will bring our minds back into alignment with our bodies. Thesis, antithesis, synthesis. In a gesture as simple as holding up your smartphone to see what's around you, we'll begin to inhabit the new world, without leaving the old one.
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Would you abort a fetus just because it wasn't yours?
The scary scenario is the one you never expect: going through IVF and discovering, weeks into your pregnancy, that your doctor put the wrong embryo in your womb.
If you think this can't happen, I have bad news: It just did.
More here.
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What's more unsettling than U.S. military planes flying over Iraq with nobody inside them?
Iranian military planes doing the same thing.
Last Thursday, Danger Room reported that according to its sources, American planes had shot down an Iranian drone in Iraqi airspace. Yesterday, the United States confirmed it. We and our friends are no longer the only nations flying remote-controlled vehicles over other countries. Instead of looking down on the enemy through the eyes of unmanned aircraft, our military personnel will increasingly find themselves on the wrong end of the camera—and eventually the missile.
The United States claims that the Iranian drone shot down on Feb. 25 spent more than an hour in Iraqi airspace and was "well inside Iraqi territory." Depending on whom you believe, it was 10, 12, 25, or 80 miles inside Iraq. One theory is that the drone was spying on a camp full of Iranian dissidents (or, to put it less nicely, terrorists). Another is that it was looking for routes to smuggle weapons into Iraq. It was unarmed and relatively unsophisticated, with a range of 90 miles (which means it almost certainly didn't go 80 miles into Iraq) and an altitude limit of 14,000 feet.
The incident raises at least three questions. First: How many other drones does Iran have, and what can they do? According to Danger Room:
In 2007, Iran said it built a drone with a range of 420 miles. In February, Iran's deputy defense minister claimed its latest UAV could now fly as far as 600 miles. ... Iran often exaggerates what its weapons can do. But, if this drone really can stay in the air for for that long, the Washington Times notes, "it could soar over every U.S. military installation, diplomatic mission or country of interest in the Middle East."
Today's Los Angeles Times adds:
Iran has been developing unmanned aviation technologies, displaying drone aircraft during military parades and incorporating them into war games along its eastern and western borders in recent years. In December, Iran said it had developed a new generation of "spy drones" that provide real-time surveillance over enemy terrain. And last month an Iranian air force officer told media Iran had created drones with a range of 1,200 miles.
The distance from Iran to Tel Aviv is about 600 miles.
Second: Who else has drones? We know, for example, that Israel, Georgia, and Pakistan have them. Iran's ability to produce them means that Iranian-affiliated miscreants will be deploying them, too. Danger Room notes:
Iran has supplied Hezbollah, the Lebanese terror group, with both models [its Ababil and Misrad drones]. Misrad drones flew reconnaissance missions in both November 2004 and April 2005. Then, in 2006, during Hezbollah's war with Israel, the group operated both Misrads and Ababils over Israel's skies. At least one was shot down by Israeli fighter jets.
Third: How will the proliferation of drones affect future wars? The emerging ability of our adversaries to do to us what we've been doing to them—invade, spy, and eventually kill without risking any personnel—is a huge problem. The number of U.S. drone strikes in Pakistan since President Obama took office is now up to six, with a casualty count exceeding 100. Imagine somebody doing that to us.
On the other hand, nobody died in the Feb. 25 incident. According to the U.S. military, before firing, our forces confirmed that "no collateral damage would result from a shoot-down." In fact, we knew more than that. We knew we wouldn't be killing any military personnel, either, since the drone's pilot was in Iran. That made it easier to shoot down the drone without triggering a political confrontation and blowing up diplomatic efforts with Iran. It's been three weeks since the incident, and Iran still hasn't mentioned it in public. If tomorrow's spy aircraft can be shot down without spilling blood and starting wars, that's not such a bad thing.
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First they came for the cigarettes. Then the soda. Then trans fats. Then fast food. Now salt.
Reuters brings the news from across the Atlantic:
Alarmed by high death rates from strokes in Portugal, deputies from the ruling Socialist party submitted a bill to parliament Friday to slash the use of salt in bread ... The bill calls for salt content to be cut to a maximum of 14 grammes per kg, or by about 25 percent, introducing fines of up to 5,000 euros ($6,435) for exceeding this. ... Socialists have the majority of seats in parliament and the bill is likely to pass without a hitch.
Yes, the socialists. Cue Rush Limbaugh.
The rationales are the same ones we've already used to legislate against trans fats and fast food. Saving lives:
According to the Portuguese Society of High Blood Pressure, a reduction of salt intake by one gramme a day on average would save 2,650 lives per year.
And saving money:
The document links excessive salt consumption to high blood pressure, which in turn causes strokes, generally reduces life expectancy and means high medication costs for the state.
We don't have a viable Socialist Party in the United States. But could salt restrictions happen here? Sure. Little more than a year go, the FDA held a hearing to consider regulating salt as a food additive. Proponents argued that we eat too much salt, that reductions could save 150,000 lives a year, and that we could lower health-care expenses.
Then, a few months ago, New York City health commissioner Thomas Frieden, with the asserted support of health departments in other cities, summoned food-company executives to the mayor's residence and urged them, in concert, to cut the salt content of high-sodium foods by 25 percent in five years, and then to cut the same percentage again in the next five years, for a total reduction of nearly 50 percent. He told the New York Times, "If there's not progress in a few years, we'll have to consider other options, like legislation."
Can Frieden and his allies deliver on the legislative threat if the food industry doesn't cooperate? I don't know. In some ways, the more interesting question is what happens if the industry does cooperate. The plan is essentially collusion between the government and an all-encompassing alliance of corporations. The aim is to deprive consumers of the targeted food item, beyond a specified limit, through "quiet, mass reduction." Frieden's team calls it "stealth health":
He wants to get most of the major food and restaurant companies to do the same thing at the same time ... Key to the plan is a gradual reduction in sodium levels. The theory is that if the salt disappears slowly enough, consumers will not notice. Dr. Sonia Angell, director of cardiovascular health for the city, said: "We've created a whole society of people accustomed to food that is really, really salty. We have to undo that."
I'm supposed to be a raving libertarian. But I like the collusion plan. My six-year-old daughter is a total salt fiend (she's been that way since birth, unlike my son), and even she couldn't finish the can of Progresso vegetable soup she requested for lunch yesterday. Why? Because it has 990 milligrams of sodium—41 percent of the recommended daily allowance. So I poured out the "broth" and substituted hot water, and she gave it the thumbs-up. That's how salty the soup was: The vegetables alone made water taste like broth.
Corn chips are the same way. The number of grocery stores near us that offer unsalted chips has dwindled to one. But that's what I keep in the house, so our kids are used to it. A month ago, we were served Fritos on an airline flight, and we could barely stand them. That's what happens when you dial down the salt volume in your life: You start to notice how absurdly oversalted most prepared foods are.
Dr. Angell is right: Today's unhealthy salt levels have been commercially manufactured. It's now much harder to escape salt than to find it. And nobody's talking about taking away your table salt. If you want to dump 990 milligrams into your soup, it's your funeral.
So here's to you, Dr. Frieden. I hope you and your captains of industry get away with your hush-hush salt-fixing scheme. I want to see whether people really miss all that sodium, or whether they get used to a saner level and don't miss a thing. And I want to see whether we can pull this off without legislation. I'll keep quiet about it if you will.
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Four months ago, this column looked at the overwhelming black vote for California's Proposition 8, which banned same-sex marriage. Why would one group, having endured discrimination, vote against the rights of another?
Answer:
Whites, on balance, have come to believe that sexual orientation, like color, is immutable. Blacks, on balance, haven't. They see homosexuality as a matter of character. "I was born black. I can't change that," one California man explained after voting for Proposition 8. "They weren't born gay; they chose it."
Here are the numbers:
In a 2003 Pew survey, 32 percent of whites said homosexuality was inborn, 15 percent said it was caused by upbringing, and 40 percent said it was a lifestyle preference. Latinos answered roughly the same way. But only 15 percent of blacks agreed that homosexuality was inborn; 58 percent said it was a lifestyle preference. A plurality of whites (45 to 39 percent) said a person's homosexuality couldn't change, but a two-to-one majority of blacks (58 to 30 percent) said it could. The pattern persists in Pew's 2006 survey. A plurality of whites said homosexuality was inborn, and a majority said it couldn't be changed. A majority of blacks said that homosexuality was just how some people preferred to live and that it could be changed.
Now comes Michael Steele, the new chairman of the GOP. Steele is black. In an interview with GQ's Lisa DePaulo, Steele concedes:
Q. Do you think homosexuality is a choice?
A. Oh, no. I don't think I've ever really subscribed to that view, that you can turn it on and off like a water tap. Um, you know, I think that there's a whole lot that goes into the makeup of an individual that, uh, you just can't simply say, oh, like, "Tomorrow morning I'm gonna stop being gay." It's like saying, "Tomorrow morning I'm gonna stop being black."
This matches what the nation's leading black Democrat, Barack Obama, has said. In a November 2007 appearance on Meet the Press, Obama declared, "I do not believe being gay or lesbian is a choice."
This is very bad news for opponents of gay marriage. As Proposition 8 demonstrated, blacks have become politically pivotal on this issue. If they follow Steele and Obama in coming around to the idea that being gay is like being black, look out.
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Two arguments have persuaded the United States to fund stem-cell research using destroyed embryos. One is that the research will save lives. The other is that the embryos, left over from fertility treatments, will otherwise be wasted.
Both arguments are now being applied to fetuses.
More here.
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Liberals want fewer unintended pregnancies and more empowerment for women. Conservatives want fewer abortions. Everybody wants to reduce HIV and other sexually transmitted infections. We can keep yapping about these things, or we can do something constructive.
Here's something constructive: female condoms. If you don't know what they are, read about them here, here, and here.
Yesterday, the Female Health Company announced FDA approval of its latest female condom. The company's previous condom was being sold for $2.80 to $4 a pop. The new one, which is made of different material (nitrile polymer instead of polyurethane) in a more automated process, will cost less. Projections range from 30 percent less to just 60 cents per condom at high volume. If a charity can cover the 60 cents, women can get it free.
With billions of male condoms in circulation, why are female condoms such a big deal? For starters, women are generally more responsible about birth control than men are. Even in the United States, 10 percent of women who end up getting abortions because they neglected contraception say their partners objected to using protection. I haven't checked the data lately, but I assure you that overseas the problem is even bigger. The more we take this decision away from men and give it to women, the more unintended pregnancies we'll prevent. That's the first thing female condoms do. They "put the power of protection in women's hands," says the Female Health Company. The director of the Center for Health and Gender Equity agrees that these condoms give "women another option in negotiating safer sex with their partners or husbands."
Second, because these condoms are designed around the vagina rather than the penis, they're unaffected by erection status. This is a big deal. Look at the company's "product" page and scroll down to the blue box outlining differences between male and female condoms. Female condoms "can be inserted prior to sexual intercourse, not dependent on erect penis," says one line of the box. Another adds: "Does not need to be removed immediately after ejaculation." Think about all the pregnancies that happen because the guy was in a rush or because the condom wasn't removed till the erection had subsided and the sperm had leaked. The female condom removes these timing problems. You put it on in advance, it's there for the duration, and you don't have to worry about the awkwardness of removing it before the guy goes limp.
In short, we're talking about a technology that compensates for human error.
Technology won't solve the whole problem of unintended pregnancies. That still requires personal and social responsibility in using contraception diligently. But better methods can certainly help us do the right thing.
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Is President Obama's decision to fund embryo-destructive stem-cell research purely scientific? Or is it also moral?
I say it's moral. So do two thinkers from opposite ends of the political spectrum. At the Hastings Center's Bioethics Forum, Daniel Callahan, a cofounder of the center, points out that supporters of stem-cell research have been wrong
to conflate opposition to stem cell research and a variety of other actions by the Bush administration. That administration was guilty of manipulating, or suppressing, scientific information on a wide range of issues, including global warming and sex education. I call that behavior patently anti-science as well as a misuse of government power. But its stem cell opposition did not encompass any distortion of the science of such research. That is not how it argued its case.
Meanwhile, in the Washington Post, Yuval Levin, a former executive director of Bush's bioethics council, argues that
science policy is not just a matter of science. Like all policy, it calls for a balancing of priorities and concerns, and it requires a judgment of needs and values that in a democracy we trust to our elected officials. ... To distort or hide unwelcome facts is surely illegitimate. But to weigh facts against societal priorities—economic, political and ethical—in making decisions is the very definition of policymakers' duty.
One reason I like these two guys is that they're clear-eyed critics of spin and self-delusion, even when the spin and delusion are coming from their own allies. On the relationship between science and politics, I particularly recommend Levin's new book, Imagining the Future: Science and American Democracy. He's right that Obama's decision doesn't moot or end the debate about using embryos. So let's honor that debate by continuing it.
Levin quotes President Kennedy, who said that many modern problems require
very sophisticated judgments which do not lend themselves to the great sort of 'passionate movements' which have stirred this country so often in the past. Now they deal with questions which are beyond the comprehension of most men.
Against this "technocratic temptation," Levin argues for democratic oversight. In principle, I agree. But the comments I've received from readers about Obama's stem-cell decision worry me. Many people on both sides seem ill-informed or self-deluded about basic scientific questions. Liberals are denying the simple fact that human embryos are the beginnings of people. Conservatives are pretending that adult stem cells are more powerful than embryonic ones. If ordinary people want to govern science policy, they need to educate themselves so they can govern well.
(By the way: To all of you who protested that torture is different from stem-cell harvesting: Of course it is. That's the nature of comparisons: The things being compared differ in many respects. The similarity in this case is that on both issues, moral objections are being dismissed as interference in a purely technical question of saving lives. That, not the merits of stem-cell research, was the point of the article.)
Second, Levin writes that in announcing his decision on Monday, Obama "argued that to deny free rein to stem cell science is to ignore and reject the promise of science as such." The president "pledged that his administration would ‘make scientific decisions based on facts, not ideology,'" and his executive order "omits any mention of ethical debate."
I think what happened Monday is more complicated than that. Based on the spin that came out of the administration over the weekend, I expected Obama to make exactly the argument Levin describes. But he didn't. Among other things, Obama said:
Many thoughtful and decent people are conflicted about, or strongly oppose, this research. I understand their concerns, and we must respect their point of view. But after much discussion, debate and reflection, the proper course has become clear. The majority of Americans ... have come to a consensus that we should pursue this research. That the potential it offers is great, and with proper guidelines and strict oversight, the perils can be avoided.
And:
I can also promise that we will never undertake this research lightly. We will support it only when it is both scientifically worthy and responsibly conducted. We will develop strict guidelines, which we will rigorously enforce, because we cannot ever tolerate misuse or abuse. And we will ensure that our government never opens the door to the use of cloning for human reproduction. It is dangerous, profoundly wrong, and has no place in our society, or any society.
Levin is right about Obama invoking facts over ideology. But that was in the context of Obama's memorandum on scientific issues generally.
It looks to me as though the administration hasn't resolved how it's going to treat these issues. The mentality Levin describes—burying moral objections and portraying embryo research as just another case of Bush's "war on science"—pervades most of the spin coming out of the White House and its feeder institution, the Center for American Progress. That's why the White House paired the stem-cell order with the announcement on restoring scientific integrity. But for some reason, Obama himself isn't entirely playing along. His remarks on Monday sounded a lot like what he has said about abortion and other social issues: acknowledging moral disagreement while striving for consensus or at least compromise. I think the administration is unresolved, and we should encourage it to acknowledge and grapple with the moral questions.
Third, Levin describes the moral question this way:
If (as modern biology informs us) conception initiates a human life, and if (as the Declaration of Independence asserts) every human life is equally deserving of some minimal protections, government support for the destruction of human embryos for research raises profound moral problems.
I cringe at this interpretation of the Declaration. Levin believes that equality means a 5-day-old embryo has the same right to life as a 5-year-old girl. I just can't buy that. I'm a gradualist. I value the 5-day-old embryo because it's on its way to becoming the 5-year-old girl. But it's not there yet. It hasn't acquired the sentience and cognition that characterize a full-fledged human being.
The Declaration says we're created with an unalienable right to liberty as well as life. But that hasn't stopped us from regulating liberties in proportion to maturity, as we do, for example, with curfews and driving. Why can't we exercise the same discretion with respect to life? Yes, life is a more basic right. But maybe that just means that instead of drawing lines after birth, as we do with liberty, we should confine our line-drawing about life to the period before birth.
Slippery slopes run both ways. Let's call that Human Nature's second law. If we don't draw moral lines against the exploitation of embryos, we may end up obliterating respect for human life generally. But if we're so afraid of that prospect that we refuse to draw lines permitting the use of any embryos under any conditions, we may end up obliterating the moral difference between embryos and full-grown people. Liberals should think seriously about the first scenario. Conservatives should think just as seriously about the second.
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Can smokeless tobacco coax people away from cigarettes?
I've written several posts defending that possibility. But a new report from the National Survey on Drug Use on Health blows a huge spitball of chaw all over the idea. Here's the key paragraph from Smokeless Tobacco Use, Initiation, and Relationship to Cigarette Smoking: 2002 to 2007:
Combined 2004 to 2007 data indicate that, among persons who had used both smokeless tobacco and cigarettes in their lifetime, 31.8 percent started using smokeless tobacco first, 65.5 percent started using cigarettes first, and 2.7 percent initiated use of smokeless tobacco and cigarettes at about the same time ... Some initiates of smokeless tobacco use may be cigarette smokers who are substituting smokeless tobacco as a way to quit smoking. Among daily smokers who initiated smokeless tobacco use, 88.1 percent were still smoking daily 6 months later.
That's pretty damning. To begin with, smokeless tobacco seems to be luring people to cigarettes at nearly half the rate it's luring people from cigarettes. Not the world's greatest bargain. But the killer number is that 88 percent. If smokeless tobacco is just supplementing cigarettes instead of helping smokers quit, then it makes no sense as an avenue for improving public health.
Am I looking at the data the wrong way? Should I be more excited about the 12 percent who went smokeless and dumped the death sticks? Let me know.
I'm still open to alternative mechanisms for delivering nicotine and weaning people off smoking. But if the tobacco industry wants any slack in selling these products, it had better work on them until they show results in terms of smoking reduction. The fist of Big Brother is coming down on cigarettes all over the world. If you tobacco shareholders want a viable business model for the future, squeeze your company's executives harder to ditch the smoke and the carcinogens.
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The same Bush-Rove tactics are being used today in the stem-cell fight. But they're not coming from the right. They're coming from the left. Proponents of embryo research are insisting that because we're in a life-and-death struggle—in this case, a scientific struggle—anyone who impedes that struggle by renouncing effective tools is irrational and irresponsible. The war on disease is like the war on terror: Either you're with science, or you're against it.
More here.
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Thanks to the octuplets mom and legislative attempts to harness the backlash against her, a political framework for fighting about in vitro fertilization is beginning to take shape. This is a new issue for most of us. Here's an attempt to start making sense of who's proposing what.
You don't often get to see a new issue form before your eyes. It's kind of like the formation of a constellation. There's a big explosion, stuff flies in all directions, and gradually the pieces begin to align in relation to one another. That's what the biotech explosion is doing to politics right now. IVF regulation is one of the constellations taking shape. Let's take a look at who the players are and what they're after.
The initial battle that has brought them together is the fight over Georgia Senate Bill 169, which I wrote about Wednesday ("Crocktuplets"). On Thursday, the bill was sent to a subcommittee. The Associated Press says the bill is dead. The Los Angeles Times says it could survive in some form if a compromise is worked out by Monday.
The bill's sponsor, state Sen. Ralph Hudgens, professes shock that it has become a flashpoint for abortion politics. "There is nothing in this law to limit abortions. I can't believe that people are reading that into it," he told the Times.
Please. We're not stupid. The bill says:
A living in vitro human embryo is a biological human being who is not the property of any person or entity. The fertility physician and the medical facility that employs the physician owe a high duty of care to the living in vitro human embryo.
And:
Nothing in this article shall be construed to affect conduct relating to abortion as provided in Chapter 12 of Title 16; provided, however, that nothing in this article shall be construed or implied to recognize any independent right to abortion under the laws of this state.
In other words, lawyers have inserted a "this doesn't affect abortion" clause so that Hudgens can claim the bill doesn't affect abortions. And we're supposed to take this seriously, even though the bill makes every embryo a human patient and stipulates that if Roe v. Wade falls, this bill can't be construed to keep abortion legal.
Did I mention that Georgia Right to Life helped Hudgens draft this supposedly abortion-neutral bill? Actually, I did. But I missed the bill's more important source: the Bioethics Defense Fund. BDF, whose self-proclaimed mission is to "address the human rights violations involved in human cloning and embryo research, abortion, and end-of-life," says two of its lawyers flat-out wrote the Georgia bill. The group adds:
BDF is grateful for the consultation and analysis provided by the National Catholic Bioethics Center, who opined that with added conscience protections and with public education on how this legislation limits violations against vulnerable human life, the Georgia bill "could be supported consistent with John Paul II's position on incremental legislation contained in his encyclical Evangelium Vitae."
A statement by Fr. Thomas Berg, L.C., Ph.D., of the Westchester Institute for Ethics and the Human Person concluded that the BDF drafted bill is "an incremental approach aimed at minimizing the harm done [and] is an essential tool for undermining the greater evils in our culture."
I know these people. I spent several days with them at the Vatican four years ago. They're as pro-life as you can get. When they call the Georgia bill an "incremental" approach toward the pope's vision, I assure you that abortion is in the crosshairs.
By the way, BDF proudly quotes a supporter's description of the Georgia bill as "model language" for legislation in other states. So you can expect more Georgia-style bills elsewhere.
That's the pro-life camp. At the other end of the spectrum, we have the American Society for Reproductive Medicine. Sean Tipton, the ASRM's public affairs director, told the Atlanta Journal-Constitution that the Georgia bill "says that decisions about how to treat [infertility] patients will not be made by patients in consultation with their physicians, but by politicians." That line comes straight out of the pro-choice playbook on abortion. It's a categorical indictment of government interference. And politically, it's highly effective.
Much of the muscle against the Georgia bill seems to have come from Resolve, a group whose mission is "to ensure equal access to all family building options for men and women experiencing infertility." Resolve may be emerging as the NARAL of IVF regulation. It says its members pumped thousands of e-mails and letters into Georgia to stop the bill and helped opponents "pack" Thursday's hearing.
In addition to the pro-life and pro-choice camps, at least two hybrid positions are taking shape. One is to broadly regulate the fertility industry, preferably under federal control. This is the agenda of the Center for Genetics and Society. CGS has a complex philosophy that could roughly be described as leftist. Here's its mission statement:
The center supports benign and beneficent medical applications of the new human genetic and reproductive technologies, and opposes those applications that objectify and commodify human life and threaten to divide human society.
The Center works in a context of support for the equitable provision of health technologies domestically and internationally; for women's health and reproductive rights; for the protection of our children; for the rights of the disabled; and for precaution in the use of technologies that could alter the fundamental processes of the natural world.
Basically, CGS is a home for people who don't trust private industry and prefer to regulate it, but from the standpoint of environmentalism, equal access, and women's rights. It's for pro-choicers who are more socialist than libertarian.
CGS wants congressional hearings and federal regulation to address the octuplets case and the fertility industry's lack of oversight. Its agenda is ambitious but unclear in its details. If you have the time, check out its proposal for "Responsible Federal Oversight of the New Human Biotechnologies."
A fourth position is to embrace government intervention but much more modestly. This is the idea behind legislation recently filed in Missouri, which would put some of the fertility industry's voluntary guidelines into law. The ASRM says self-regulation is already preventing octuplets-type abuses. But Missouri state Rep. Rob Schaaf has filed legislation to enforce these limits. Unlike the Georgia bill, Schaaf's bill is short and direct. Its operational text consists of one sentence:
When treating infertility, physicians within the state of Missouri shall not implant more embryos into a human than the current recommendations set forth by the American Society for Reproductive Medicine, or its successor.
Schaaf argues that "it is within the realm of the state to make sure that doctors don't participate in things that are harmful to people." So if you don't trust complex regulatory schemes like the Georgia bill but aren't afraid of government intervention in the fertility industry per se, piecemeal measures like this one may be the way to go.
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Thanks to the eagle-eyed Center for Genetics and Society, I just learned that the fertility company that was advertising eye-, hair-, and skin-color selection in human embryos (which I've provisionally nicknamed Color ID) has dropped the plan, at least for now. Here's the full text of the statement released Monday by the Fertility Institutes:
In response to feedback received related to our plans to introduce preimplantation genetic prediction of eye pigmentation, an internal, self regulatory decision has been made to proceed no further with this project. Though well intended, we remain sensitive to public perception and feel that any benefit the diagnostic studies may offer are far outweighed by the apparent negative societal impacts involved. For those patients with albinism or other ocular pigmentation disorders, we continue to offer preimplantation genetic diagnosis in general but will not be investigating the genetics of pigmentation of any body structures.
It's not clear how long the company's decision "to proceed no further" will last. The statement is titled "Eye and Hair Color Program Suspension."
CGS calls this a mere "postponement" and urges Congress to step in. "Like the financial industry, the fertility industry has shown that it is incapable of regulating itself," the group argues. The Fertility Institutes' announcement of a "self-regulatory decision" to suspend Color ID seems to have been crafted to head off such regulation.
What's really interesting about the statement is the reference to being "sensitive to public perception." I wonder whether that evolving factor—public opinion about aesthetic embryo selection—will determine when the suspension ends.
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Are the burdens of the presidency graying Barack Obama? Are his gray hairs a sign of life-shortening stress?
Today's New York Times front page makes it sound that way:
For a guy who prides himself on projecting a stress-free demeanor, the changes above his temples are speckled evidence that perhaps the psychological and physical strains of the job—never mind the long process of winning it—are in fact taking something of a toll. (Experts say stress can contribute to whitening locks.) ...
But with the economy struggling, two wars raging and countless other pressures facing him, the president is very likely to see additional signs of wear and tear in the mirror each morning. "Presidents age two years for every year that they're in office," said Dr. Michael F. Roizen, co-founder of RealAge, a Web site that tells you how much older your body really is because of all that smoking and drinking you have been doing. ... Rapidly lightening locks are just one sign that the job is getting to America's presidents.
The front page of today's Washington Post Style section agrees:
Are times so stressful—a plummeting economy and two wars—that our young president is going grayer a mere six weeks into the job? ... With each debate, after every primary fight, it seems Barack Obama's tightly clipped hair became just a dash saltier. ... And it's an article of faith, backed by photographic evidence, that the Oval Office ages the men in it. Look no further than George W. Bush and Bill Clinton.
It's natural to look at the president's gray hair and take it as a sign of job stress. But guess what's even more natural? Gray hair. The Times' headline—"For Young President, Flecks of Gray"—implies that Obama is graying prematurely. Not true. According to a scholarly review published three years ago in the Journal of Investigative Dermatology, "Age of onset of graying also appears to be hereditary, developing usually in late fourth decade. Thus, the average age for Whites is mid-30s, for Orientals late-30s, and for Africans mid-40s, such that by 50 years of age, 50% of people have 50% gray hair."
Obama is 47. As the Times and Post photographs show, he's only marginally gray. He's right on schedule.
Is his gray hair a sign of premature aging, "wear and tear" and "taking a toll," as the newspaper stories imply? Sorry. Evidence published in Medical Hypotheses suggests otherwise:
An office and autopsy study was performed to see if early graying was associated with increased morbidity, earlier age at death, and specific cause of death. 195 consecutive office patients over the age of 40 were studied to see if premature graying of scalp hair (50% or more gray before age 50) was associated with increased incidence of disease before age 50 ...For fathers, mean age at death if prematurely gray was 68.27 years; if not prematurely gray, 66.03 years ... For mothers, the values were 70.55 years and 70.37 years respectively ... 874 autopsy patients dying over a 23-year period (1966-1989) were studied to see if the median age at death (of patients 50% or more gray) differed for any of the six categories of disease (myocardial infarction, congestive heart failure, cancer, stroke, pneumonia/bronchitis, or cirrhosis of the liver/GI problems) when compared to the entire autopsy sample of 19 categories of disease ... This dual office and autopsy study provides no evidence to support the contention that early gray hair is a risk factor.
The study, published in 1991, is getting a bit old. But then, aren't we all? Bill Clinton was 46 when he became president. George W. Bush was 53. That's perfectly consistent with the 50-50-50 rule (50 percent of people being 50 percent gray by age 50). There's nothing premature about their grayness—or Obama's. Being president may be bad for your health. But your gray hair tells us nothing.
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An update on the human egg market, courtesy of Reuters:
Drawn by payments of up to $10,000, an increasing number of women are offering to sell their eggs at U.S. fertility clinics as a way to make money amid the financial crisis. ... The Center for Egg Options in Illinois has seen a 40 percent increase in egg donor inquiries since the start of 2008. New York City's Northeast Assisted Fertility Group said interest had doubled and the Colorado Center for Reproductive Medicine said it had received 10 percent more inquiries.
One clinic's egg donation manager explains that the bad economy "encourages women to find creative ways to make money." It's an interesting use of the word creative. In this case, two kinds of creativity seem to be involved. One is the invention of egg donation in the first place. Selling eggs was impossible until doctors learned how to extract, preserve, fertilize, and transfer them for successful implantation. These breakthroughs made eggs transferrable and commercially valuable.
The second kind of creativity goes hand in hand with the first. You don't normally think of selling your body's parts or products. But bad times can make you think hard. One reason you might not have thought of selling something from your body is that the idea felt unnatural or somehow made you uncomfortable. But for $5,000, with bills to pay and no other income prospects, you decide you can get over those feelings.
Economics clearly drives the donation market. Two years ago, Reuters notes, a study found that the average payment to an egg donor in the United States was $4,216. But the average sperm donor in New York City gets only $60 per deposit. And sperm banks, unlike egg donation programs, are reporting no recent increase in donations. The money's not good enough.
The next question is whether money can persuade you to donate not just a body product, but a body part. In principle, half the world's kidneys are expendable. People are already buying and selling them on the global market, regardless of laws. Some reformers are proposing to replace this black market with a regulated system of incentives ranging from $15,000 to $40,000. If $5,000 is enough to make people think creatively about donating their eggs, $15,000 might well be enough to do the same for kidneys.
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Under a Georgia bill, if you're 39, your doctor is forbidden to fertilize more than two of your eggs per treatment cycle. Take all the hormones you can stand, make all the eggs you want, but you get two shots at creating a viable embryo, and that's it.
How does this restriction "protect the mother" and "reduce the risk of complications" for her? It doesn't. ... So why limit the number of embryos created per cycle? Because the bill's chief purpose isn't really to help women. It's to establish legal rights for embryos.
More here.
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In its final hours, the Bush administration implemented a regulation expanding the right of medical professionals to abstain from practices they find objectionable. On Friday, the Obama administration moved to "review" and eventually repeal the regulation. Organizations on all sides of the debate issued press releases responding to Obama's move. This table tells you everything you need to know about the politics of the fight:
1. Mentions of "abortion":
Christian Medical and Dental Association: 19
Family Research Council: 6
House Minority Leader John Boehner: 4
NARAL Pro-Choice America: 1
National Women's Law Center: 0
Center for Reproductive Rights: 0
Planned Parenthood Federation of America: 0
2. Mentions of "contraception" or "birth control":
NARAL Pro-Choice America: 3
Planned Parenthood Federation of America: 1
Center for Reproductive Rights: 1
National Women's Law Center: 1
House Minority Leader John Boehner: 0
Family Research Council: 0
Christian Medical and Dental Association: 0
To sum up: The liberal groups don't want to mention that the regulation involves abortion, and the conservative groups don't want to mention that it also covers the right to withhold birth control. Why? Just look at the polls. As Rachel Laser of Third Way astutely puts it, "If the president kept in place the conscience clause in regard to abortion but reversed it in regard to birth control, most Americans would agree that's common ground." And that's exactly what the Obama administration aims to do, according to a Health and Human Services official who spoke to Reuters:
The wording was vague enough to let health professionals invoke the conscience clause for things like contraceptives, family planning and counseling for vaccines and blood transfusions, the agency official said. ... "We recognize and understand that some providers have objections to providing abortions. We want to ensure that current law protects them," the official said. "But we do not want to impose new limitations on services ... like family planning and contraception that would actually help prevent the need for an abortion in the first place."
If Obama convinces the public that this is what he's doing, then politically, he'll be fine. And morally, he'll be well-justified.
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What's dumber than driving while talking on a cell phone? Driving while talking on a cell phone and breast-feeding a baby.
Genine Compton of Kettering, Ohio, come on down! You're the next contestant on "I used my child as a human air bag."
According to local police, Ms. Compton admitted to this feat of triple-tasking on Thursday. Here's the Dayton Daily News transcript of a fellow driver's call to the authorities:
I tried to say something to her. She literally has the little girl on the steering wheel and I said, "I can't believe you have that kid in your lap," and she said, "You want to pop your titty out and breastfeed this kid?" That's what she said to me. I'm like, "You can feed your kid when you stop." It's like wet out here. It's full of traffic. It's ridiculous. She's got like three other kids in the car.
Compton's defense? According to the police, she said "she does not deprive her child when the child is hungry."
Apparently, in our high-pressure, gadget-driven world, people have become so accustomed to multitasking that they've stopped noticing it as an elective option. No one's asking you to deprive your child. If she's hungry, by all means, feed her. And if you need to take a call while you're at it, go ahead. Just don't drive while you're doing either of these things. Is that so hard to understand?
It seems that we now think of driving as a background activity. Whatever comes up in the foreground—phone call, text message, hungry baby—gets dealt with as though it's the first thing demanding our attention. Like a projectile following a straight line in empty space, we feel at rest in motion. But we aren't projectiles, we don't follow straight lines, and the space around us isn't empty. In traffic, inertia kills.
And that doesn't just go for the lady breast-feeding at the wheel. It goes for the child-safety enthusiast who reports her. Nobody seems to have flagged this bit from the Daily News story:
"I'm following right behind her right now on Far Hills Avenue," the caller said as he spoke to a Kettering dispatcher in a recording of his non-emergency call that was released by police. ...
You're following right behind her? While talking on your phone? So you can report her for multitasking at the wheel? Hello?
If you see somebody driving while distracted, feel free to report the culprit. But first, practice what you preach: Pull over.