Tuesday, September 30, 2008

The Phenomenon of "Panic!" Governance

Politics always goes through a period of ups and downs. But lately it seems things have been rapidly declining. Since 9/11, politics has largely been dominated by what I will call "Panic!" Governance.

Don't get me wrong. It's not that 9/11 was the start of the phenomenon of "Panic!" Governance. The Cold War era, for example, saw more than its fair share of government's playing on the public's (mis)perception of the dangers they faced. This video, for example, clearly illustrates this point.

But many things have accelerated, and intensified, the phenomenon of "Panic!" Governance. Dramatic and tragic events, ranging from 9/11, Katrina and the current economic crisis, coupled with sensationalist journalism and a public hooked on "Reality TV", have helped feed an insatiable thirst for near apocalyptic nightly news.

The three most obvious examples of this are (1) the war on terror (2) climate change and (3) the current economic woes. Each of these are real legitimate concerns, I am not suggesting that they are not. But all three have been vigorously championed by advocates who seek to make the case for "Panic!" Governance.

Three features are present in instances of "Panic!" Governance. Firstly, it is claimed that inaction will result in grave and serious harm. So if we do not invade Iraq they will unleash their weapons of mass destruction upon the world. If we don't combat climate change immediately the earth will warm to a level that makes human life intolerable. And the current credit crunch will lead to a new depression.

In all of these cases the magnitude and certainty of the harms are blown way out of proportion. Some may retort that exaggerating a particular danger (like climate change) is necessary in order to motivate people to support serious change. But distorting the facts like this caused many more harms, harms that outweigh those that will result from not tackling (1), (2) and (3).

In additional to exaggerated claims concerning inaction, "Panic!" Governance also involves pursuing action that is premised primarily on the desire to avert the proposed disaster (at any cost!) rather than sound empirical evidence concerning the cost-effectiveness of the proposed measure. So "Panic!" Governance creates a climate of hysteria that actually impedes serious, reflective policy-making concerning how to sensibly tackle the challenge in question.

And thirdly, because "Panic!" Governance creates a climate inhospitable to dissenting opinions, the measures pursued are not only ineffective, they can actually create further harms that are then characterized as "unintended" or "unforeseen" because the policy pursued was rushed and received little critical scrutiny.

And the combination of these three features of "Panic!" Governance- its inflated claims concerning the danger of particular problems, its desire for action of any kind (rather than sensible action), and its "you are either with us or against us!" mentality- result in many serious problems.

One problem with "Panic!" Governance is that by distorting reality in this fashion we ignore other, more immediate and severe, harms. Where are the nightly news reports on the 300,000 U.S. deaths a year associated with obesity and excess weight, or the 400,000 deaths a year associated with cigarette smoking? Where are the economists singing the praises of increased human longevity- like the fact that the increased longevity between the years 1970 and 2000 added about $3.2 trillion per year to national wealth in the United States? So the diseases of aging, for example, are far more immediate and pressing problems, and yet they will not make the evening news (very often) or dominate serious policy debates.

Part of the reason for this is that priorities have been hijacked by the "shock-and-awe" mentality of a population that suffers from attention deficit. We need to jump from one colossal disaster to the next... for the fate of humanity has become the latest and most interesting "reality TV show".

So distorting reality in this way means that we are unlikely to get support for causes that are very pressing and in need of attention. It's a case of the boy who cried wolf too many times. Indeed, this is precisely what has happened to the Bush Administration. Americans no longer believe him when he says that immediate action is needed to avert greater economic woes.

Secondly, once we distort the magnitude of the harm of a particular problem, it is easier to get the wrong kind of support for tackling the problem. When there is no time to debate or seriously consider the options, we tend to adopt a "any solution is better than none!" mentality. And this is most clear in the current economic crisis. "The bailout must be passed now!" "We don't have time to hear dissenting opinions, or to consider alternative proposals". And thus "Panic!" Governance increases the likelihood that the solution we end up pursuing is the wrong solution.

The same applies to climate change, and so it is not only the Bush Administration that is guilty of fostering "Panic!" Governance. Even Al Gore is guilty of tapping into this mentality (as is my own Liberal Party). Getting a consensus on the fact that there has been an increase in global temperature, caused by humans, is one thing. But figuring out how we can realistically and responsibly respond to these challenges is enormously complex and difficult. It will take time just to figure out how best to proceed. Climate change is a global problem, and getting a global solution is extremely difficult when we consider the fact that the world consists of countries that will be impacted by climate change in different ways- some for the better, some for the worse- and these countries have different levels of population and different levels of economic development. By many environmentalists who raise the alarm bells seem to think that getting the solution right is either self-evident or irrelevant. "Better to do something, anything [even if it does more harm than good] than be seen to be doing nothing".

So the "Panic!" Governance mentality puts all the emphasis on acting, and acting NOW!, rather than encouraging open debate and the gathering of reliable empirical data concerning how best to proceed. Anyone who opposes measures like the Patriot Act, or a carbon tax, is demonized as "unpatriotic" or a climate sceptic. When at its greatest force, "Panic!" Governance creates a chilling intellectual climate where any dissenter risks political suicide. And so the force of the extremism tends to grow unabated.

And finally, and most importantly, "Panic!" Governance undermines democracy itself. It leads to a Press more interested in covering sensationalist stories that keep viewers coming back for more than in enhancing public debate. It leads to a general public fed lies and distortions; a public that losses faith in politicians and the institutions of government. And thus the tragic irony of "Panic!" Governance is that it creates its own crisis- the crisis of democracy. The demise of democracy...now that is a genuine crisis in need of urgent and immediate attention.


Public Health Ethics Paper on Aging Research (Now Published)

My latest paper entitled "Aging Research: Priorities and Aggregation" is now available on advance access for the journal Public Health Ethics. Here is the abstract of the paper:

Should we invest more public funding in basic aging research that could lead to medical interventions that permit us to safely and effectively retard human aging? In this paper I make the case for answering in the affirmative. I examine, and critique, what I call the Fairness Objection to making aging research a greater priority than it currently is. The Fairness Objection presumes that support for aging research is limited to a simplistic utilitarian justification. That is, a mode of justification that is aggregative and permits imposing high costs on a few so that small benefits could be enjoyed by numerous recipients. I develop two arguments to refute the Fairness Objection. The Fairness Objection mischaracterizes the utilitarian argument for retarding human aging. It does so by invoking the fallacious conceptual distinction between "saving lives" and "extending lives", as well as making a number of mistaken assumptions concerning the likely benefits of retarding human aging. Secondly, I argue that the case for tackling aging can be made on contractualist, in addition to utilitarian, grounds. Because the harms of senescence are "morally relevant" to the harms of disease, contractualists can permit aggregation within lives. And thus no one could reasonably reject, I contend, a principle that makes the aspiration to tackle human aging more of a priority than it currently is.


Thursday, September 25, 2008

Eugenics: Past and Present

Eugenics is the study of ways to improve the genetic constitution of humanity.

Historically, eugenics has inspired egregious social practices such as the sterilization of those deemed "unfit" for reproduction. Canada’s own Tommy Douglas, voted by the CBC as Canada’s “greatest Canadian”, espoused such unjust eugenic policies.

The most abhorrent example of eugenics gone awry was the Nazi regime, which lead to the murder of millions deemed a threat to the purity of the gene pool.

It is important to reflect back on past eugenic movements, for the lessons of the past can help us address the challenges we now face as new genetic technologies (e.g. tests for genetic disease) become available.

Is eugenics, understood as the aspiration to improve humanity’s heredity, necessarily unjust?

I believe it is not. In fact, justice can, in certain circumstances, *require us* to pursue measures that can be accurately described as “eugenic”. But to see how we must be clear about what was unjust about past eugenic policies. And that is my exclusive focus today.

The problems with past eugenic policies were basically two-fold. Firstly, the ends such practices sought to achieve were not morally or empirically sound. So aspirations such as “racial hygiene”, for example, are not morally defensible aspirations. Nor were past eugenic policies grounded in sound science. Assumptions about the heredity of criminality, work ethic, etc. were based on prejudice and dogma, not scientific evidence. So the particular ends of past eugenic movements were not defensible. This does not mean that any aspiration to improve humanity’s heredity is invalid. But those premised on prejudice and pseudoscience will fail the test of being defensible societal goals.

Secondly, past eugenic policies violated an important moral dictum: *the end cannot justify the means*. Even if one could articulate a laudable eugenic goal- like the reduction of disease- it does not follow that any means for achieving that end will be justified. So much more thought must be given to the *means* for achieving these ends. They must be rationally connected to the end, and proportionate, for example. Past eugenic policies also failed this second test.

But we do not need to look to the past to see how these lessons are still pertinent today. To set the context for the discussion that follows, I want you to ask yourself how you would respond to the following scenario.

A couple is at a higher than average risk of having a child with a genetic disorder or disability. Furthermore, let’s assume that society has decided that the goal of reducing the prevalence of disease and disability is a laudable goal. And thus they are considering what action, if any, should be taken to either encourage, or possibly compel, the at-risk couple from giving birth to a child with this condition.

So the government considers many possible measures of varying degrees of intrusiveness. Some legislators propose encouraging prospective parents, who are known to be at an increased risk, of undergoing genetic counseling. The government could even offer this service for free. Maybe even offer at-risk couples a small financial incentive for undergoing genetic counseling. Other legislators take a more harsh stance. They believe we should require at-risk parents to undergo genetic counseling. And some go yet even further, claiming such parents should be required to undergo genetic counseling and genetic tests. And some worry that even if these parents undergo the test, and it turns out they do have a high risk of passing on a genetic disorder, or are actually pregnant and prenatal tests indicate the child has a condition or disorder, the parents do not have to avoid conception or birth. So one hardliner says we should go even further yet. “Let’s make it illegal for these people to have a baby!” cries one excited law maker. “Heck, let’s put them in jail for having intercourse!”.

I suspect none of us will share the fanaticism of this final hardline proposal. Of the possible forms of intervention which are up for consideration, gross violations of reproductive freedom (like compelled abortion or the criminalization of intercourse) would be easily ruled out. For such a policy violates the second point raised above- that the ends cannot justify the means. While it is laudable to take preventative steps to ensure healthy children are born, we cannot pursue this aim in a zealous fashion that unjustly infringes on the liberties of prospective parents. While it is tricky to say precisely where we draw the line, the proposal of our excited hardliner clearly crosses that boundary.

Well, the reality is that many countries, including my own country (Canada), actually have laws on the books that do precisely what this hardliner proposes. We actually threaten to imprison people who have an increased risk of creating children with genetic abnormalities! Few people realise this. If you travel over to here, you will see Canada’s Criminal Code. And under Section V, titled SEXUAL OFFENCES, PUBLIC MORALS AND DISORDERLY CONDUCT, you will see that incest is a criminal offence punishable by up to 14 years in prison.

What is the justification for criminalizing incest (among consenting adults)? The most obvious justification would be a eugenic justification. And while the aim of reducing the prevalence of genetic diseases and abnormalities can be a laudable goal, criminalizing the sexual behavior of those who might be at an increased risk of conceiving children with a disorder or disability is not justified. Such a law suffers the same defects as past unjust eugenic policies. It is based on poor empirical evidence (e.g. concerning the increased risk and severity of the harm of inbreeding) and the harms of the law are disproportionate compared to any purported benefits.
In the latest issue of The Journal of Medical Ethics I have this short piece which addresses incest and the case of Patrick Stübing and his sister Susan Karolewski. See this video for details of their particular case.

The case of criminalizing incest raises many difficult questions. And grappling with these issues are important for they could determine how we respond to other scenarios where analogous stakes might be at risk. Many couples that are free to procreate under current law might actually have a higher risk of passing on a severe genetic disorder or disability. And if we can justify criminalizing the procreative choices of those closely related to each other, are we not lead down the path prescribed by the overzealous hardliner I noted above?

Perhaps there are other justifications one might invoke to make the case for criminalizing incest. Protection of the family, for example. I believe these arguments will also face difficult challenges, though I won’t pursue these points here.

But I think the case of incest law is an interesting example to consider for it illustrates how the concerns of past eugenic movements are still alive today.


Wednesday, September 24, 2008

Obama's Stance on Science and Technology

Nature invited the US Presidential Candidates to answer 18 science-related questions in writing. Barack Obama agreed to answer these questions, while John McCain's campaign (surprisingly?!) declined.

You can read all of Obama's answers to the questions here. Here is a small sample:

What will be your highest priority in the science and technology arena?

Barack Obama: I am committed to strengthening US leadership in science, technology and innovation, and doing so will be a central priority for my administration. Our talent for innovation is still the envy of the world, but we face unprecedented challenges that demand new approaches. For example, the United States annually imports $53 billion more in advanced technology products than we export. China is now the world's number one high-technology exporter. This competitive situation may only worsen over time because the number of US students pursuing technical careers is declining. The United States ranks 17th among developed nations in the proportion of college students receiving degrees in science or engineering; we were in third place thirty years ago.

Federally supported basic research, aimed at understanding many features of nature — from the size of the Universe to subatomic particles, from the chemical reactions that support a living cell to interactions that sustain ecosystems — has been an essential feature of American life for over fifty years. While the outcomes of specific projects are never predictable, basic research has been a reliable source of new knowledge that has fuelled important developments in fields ranging from telecommunications to medicine, yielding remarkable rates of economic return and ensuring American leadership in industry, military power and higher education. I believe that continued investment in fundamental research is essential for ensuring healthier lives, better sources of energy, superior military capacity, and high-wage jobs for our nation's future.

....Finally, we are reducing support for science at a time when many other nations are increasing it, a situation that already threatens our leadership in many critical areas of science.

This situation is unacceptable. As president, I will increase funding for basic research in physical and life sciences, mathematics and engineering at a rate that would double basic research budgets over the next decade to support our scientists and restore US scientific leadership.

Many scientists are bitter about what they see as years of political interference in scientific decisions at federal agencies. What would you do to help restore impartial scientific advice in government?

Obama: Scientific and technological information is of growing importance to a range of issues. I believe such information must be expert and uncoloured by ideology. I will restore the basic principle that government decisions should be based on the best-available, scientifically valid evidence and not on the ideological predispositions of agency officials or political appointees. More broadly, I am committed to creating a transparent and connected democracy, using cutting-edge technologies to provide a new level of transparency, accountability and participation for America's citizens. Policies must be determined using a process that builds on the long tradition of open debate that has characterized progress in science, including review by individuals who might bring new information or contrasting views. I have already established an impressive team of science advisers, including several Nobel laureates, who are helping me to shape a robust science agenda for my administration.

Do you believe that evolution by means of natural selection is a sufficient explanation for the variety and complexity of life on Earth? Should intelligent design, or some derivative thereof, be taught in science class in public schools?

Obama: I believe in evolution, and I support the strong consensus of the scientific community that evolution is scientifically validated. I do not believe it is helpful to our students to cloud discussions of science with non-scientific theories like intelligent design that are not subject to experimental scrutiny.

Would you lift President Bush's ban on federal funding for research on human embryonic stem-cell lines derived after 9 August 2001? Under what conditions do you find it acceptable to create a human embryonic stem-cell line?

Obama: Stem-cell research holds the promise of improving our lives in at least three ways — by substituting normal cells for damaged cells to treat diabetes, Parkinson's disease, spinal-cord injury, heart failure and other disorders; by providing scientists with safe and convenient models of disease for drug development; and by helping to understand fundamental aspects of normal development and cell dysfunction.

For these reasons, I strongly support expanding research on stem cells. I believe that the restrictions that President Bush has placed on the funding of human embryonic stem-cell research have handcuffed our scientists and hindered our ability to compete with other nations. As president, I will lift the current administration's ban on federal funding of research on embryonic stem-cell lines created after 9 August 2001 through executive order, and I will ensure that all research on stem cells is conducted ethically and with rigorous oversight.

I wonder why the McCain campaign declined to participate. Perhaps they read this story and figured there was no need to worry about the state of science and technology in America.


Monday, September 22, 2008

Main Menu (Sept 2008)

Friday, September 19, 2008

NBT Article on Balancing Efficiency and Safety

The latest issue of Nature Biotechnology has an interesting News Feature piece on the FDA's Office of Oncology products. How do you strike a sensible balance between efficiency and caution? Here is a sample:

The US Food and Drug Administration often finds itself between a rock and a hard place when balancing safety and efficacy decisions for therapies targeting life-threatening conditions, but the recent approval of cancer drug Avastin (bevacizumab) for breast cancer seems to have brought out a wider than usual array of critics, with some taking surprising positions. The Genentech drug, in use since 2004 for colon cancer, was approved by the FDA this February for HER2-negative patients. The approval was based on progression-free survival data—a surrogate clinical trial endpoint that many oncologists would like to see used more often. But that decision went against an advisory committee's advice, raising the suspicions of Senator Charles Grassley (R-IA), who is calling for an investigation into using surrogate markers in drug approvals (Box 1). At the same time, a vocal minority of companies, patient advocates and researchers continues to argue that the Office of Oncology is raising the bar too high for cancer drugs with novel mechanisms. Who is right?


Can Magic Fairies Save America?

Forget about the war on terror, forget about the dire economy, this story in Time does not bode well for the future of America.

When asked "Have you ever been protected by a guardian angel?" 55% of respondents said "yes!". Where is Richard Dawkins when you really need him? One of the contributors to the story says that this study suggests that "Americans live in an enchanted world" and engage in "casual mysticism".

Perhaps that helps explain the dire state of affairs! Why rely on instituting a decent government when you can count on magic fairies to look after you? This reinforces my point that dogma is one of the greatest threats to democracy and decent government.


Wednesday, September 17, 2008

FOXO3A Gene Associated with Human Longevity

...so says a recent study published in the latest issue of Proceedings of the National Academy of Sciences. Here is the abstract:

Human longevity is a complex phenotype with a significant familial component, yet little is known about its genetic antecedents. Increasing evidence from animal models suggests that the insulin/IGF-1 signaling (IIS) pathway is an important, evolutionarily conserved biological pathway that influences aging and longevity. However, to date human data have been scarce. Studies have been hampered by small sample sizes, lack of precise phenotyping, and population stratification, among other challenges. Therefore, to more precisely assess potential genetic contributions to human longevity from genes linked to IIS signaling, we chose a large, homogeneous, long-lived population of men well-characterized for aging phenotypes, and we performed a nested-case control study of 5 candidate longevity genes. Genetic variation within the FOXO3A gene was strongly associated with human longevity. The OR for homozygous minor vs. homozygous major alleles between the cases and controls was 2.75 (P = 0.00009; adjusted P = 0.00135). Long-lived men also presented several additional phenotypes linked to healthy aging, including lower prevalence of cancer and cardiovascular disease, better self-reported health, and high physical and cognitive function, despite significantly older ages than controls. Several of these aging phenotypes were associated with FOXO3A genotype. Long-lived men also exhibited several biological markers indicative of greater insulin sensitivity and this was associated with homozygosity for the FOXO3A GG genotype. Further exploration of the FOXO3A gene, human longevity and other aging phenotypes is warranted in other populations.


Monday, September 15, 2008

Health Genetics and HIV

In a number of previous posts I have emphasized the importance of transcending the "disease model" of medicine. Whether it be "health genetics", or positive psychology , or the study of longevity genes, examining why some do not develop disease or become ill may actually help us better address human disease and suffering.

Tackling HIV may prove to be another great example of this point. Today, like yesterday, and like tomorrow, approximately 6 800 people will become infected with HIV, and more than 5 700 will die (see here). However, some individuals who are are at a very high risk of contracting the disease (like prostitutes) never contract HIV. Why is this? And how could this information better position us for tackling HIV?

The Sept 5th issue of Science has an important report that helps answer these questions here. Here is a sample:

The human Apobec3 family has been implicated in the control of HIV-1 infection, but HIV-1 encodes Vif, which thwarts the actions of Apobec3G (A3G) and Apobec3F (A3F) (23–26). Compromised A3G/A3F antiviral activity may therefore contribute to the generally poor neutralizing antibody response observed in HIV-1 infection (27). Vif antagonists, if and when they are available, may enhance the generation of effective humoral immune responses against HIV-1. Finally, studies exploring the apparent intrinsic resistance of individuals who are extensively exposed to HIV-1, yet remain uninfected, have genetically mapped this phenotype to chromosome 22q12-13 (12), a location distinguished by a tandem array of the seven human Apobec3 family members. Genome-wide studies of the entire human Apobec3 locus, with particular emphasis on functional differences induced by alternative splicing, are clearly merited to fully explore the potential contribution of this gene family to HIV resistance, neutralizing antibody production, and disease progression.

The NIH has a press release about the research here. The Apobec3 gene may influence anti-HIV antibody production, and this could explain why some at risk individuals do not develop the disease. These insights might help with the development of new HIV drugs and vaccines.


Why I Won’t be Voting for the Liberals

In 1988 I was eighteen, and it was the first time I was entitled to vote in a Canadian federal election. The central topic of that election was the Free Trade Agreement. I was very enthusiastic about politics and a supporter of the Liberals. We lost that election, but I have always supported the Liberals since then.

Unfortunately this year, twenty years later, I will not be voting for the Liberals. And while I seldom blog about substantive issues in Canadian politics, today is an exception. For I feel that the vast majority of our political parties and leaders have let Canadians down in a big way. And the biggest failure, in my opinion, has been Dion’s leadership of the Liberals. Typically the Liberals are a party which balances noble aspirations with sage policy, but since the departure of Paul Martin back in 2006 things have gone seriously awry for the Liberals.

So what is the main shortcoming of Dion and the Liberal's platform this election? Basically, by collapsing the Liberal Party into the Green Party, Dion has jeopardized the core values and principles that should be at the forefront of any decent government.

Head over to the Liberal’s website to see the details of their proposed “Green Shift”, the central policy issue Dion has decided to hang the fate of the Liberal’s on. Dion begins by stating that “the time has come to do what is right, not what is easy”. I do not disagree with Dion that climate change is a pressing problem, and action is necessary; but his decision to make this *the* issue of the election, and a new carbon tax the central policy of his government, will cost the Liberals the election. And rightfully so.

The aspiration to have greater control over the Global temperature may be a noble aspiration, but it is a *global problem and challenge* and thus requires a global solution. So nothing Canada does to reduce our own carbon emissions will, by itself, have any real impact on climate change. The actions of the US, China, India and the rest of the world will determine what the global emissions of green house gases will be. So there is no Canadian solution to climate change. We are deluding ourselves if we believe there is. A political party that premises their whole domestic political campaign on such an agenda is either very insincere or completely inept. Either disqualifies them from winning my vote.

Secondly, even if one does believe that the most important issue facing Canadians is tackling climate change, it doesn’t follow that the best solution need come from the federal government rather than provincial governments. The challenges facing each Canadian province are different, and so I believe it is reasonable to assume that the most efficient, cost-effective solutions will come from provincial governments rather than an ambitious political campaign that proposes re-shaping the fundamentals of distributive taxation in the hopes of winning an election.

And even if one does believe that tackling climate change is the most important issue facing Canadians, and one that Canadians could solve, and one the federal government is best positioned to tackle, one could reasonably question the wisdom of a carbon tax. And this touches on some of the biggest reservations I have about the Green Shift. The central idea of the Shift is that tax breaks will be given and then the government will tax people on their pollution. Call me an old fashion welfare stater, but I am not willing to give up on the central tenets of distributive justice this easily. The amount one is taxed should be primarily determined by one’s *income and wealth*, not by how much one pollutes. It is easy to demonize those who live in less energy-efficient homes, or who have many children, as “polluters in need of punishment”. But I have no interest in supporting a government that buys into that mindset.

The last time I voted for the Liberals Paul Martin had a solid track record with the economy and a commitment to improving the healthcare of Canadians. Little in Dion’s Green Shift resonates with my moral sensibilities or comprehension of sound government policy. The fact that Dion believes taxing individuals for polluting will also combat poverty and create “Green” jobs (what are they?) simply baffles me. Recognising the limits of what government can actually achieve is one of the most important virtues of a political leader. Dion may have his heart in the right place, but that is not enough for good government. In fact, good intentions alone can often have disastrous consequences. By putting all his eggs in the “let’s try to have greater control over the Global temperature” basket, Dion has done little to convince Canadians that he could lead a government that would reduce the national debt, tackle poverty, unemployment, healthcare, education, etc. Anyways, that is my two cents worth.

That is all I want to say about this coming election. When the Liberals lose this election I hope they will seriously reconsider their central values and principles, and offer Canadians a Party that seriously engages with the complex challenges Canadians face this century.


Friday, September 12, 2008

9/11 and Community Service

Yesterday Barack Obama and John McCain discussed community service and the importance of showing respect to the victims of 9/11 by contributing to one's country and communities (see here). This is a very important issue and one worthy of much greater public attention and debate.

So I thought it appropriate to reproduce the opinion piece I was commissioned to write for Newsday back in the spring of 2005. Many reactions I received from that article raised issues that arise in this current debate. For example, many readers felt that my comparison of the contribution of volunteer firefighters with literacy volunteers was unfair. I also received a letter from an irritated fire chief who expressed the opinion that I keep my philosophizing to myself! Well, now that the nominees for President have helped spur a civil discourse about the importance of community service, hopefully that will address the kinds of concerns I raise in the article. Yet I fear many are still missing the real meaning of "community service", for if they did they would strongly resist bill's like this one in Pennsylvania.


Rewards, yes, but tax breaks, no
[published in Newsday, May 1st 2005]

By Colin Farrelly

Emergency personnel provide an essential public service, and many risk the ultimate sacrifice — their own safety. In the aftermath of 9/11, gratitude for the heroism and dedication of these workers has inspired support for tax relief for volunteer firefighters and ambulance workers around the United States.

Legislation is now being proposed in Rockland County, for example, that would allow such volunteer workers to shop tax-free. “Any kind of incentive you can give the volunteers is a good thing,” the bill’s sponsor has said.

For Long Island, in 2004 Gov. George Pataki signed into law legislation that increased the property exemption benefit on the homes of eligible Suffolk fire and ambulance volunteers. They are permitted a 10- percent exemption on the assessed value of a home, rather than the previous cap of $3,000. Yet, in February, the Harborfields Central School Board decided not to grant the tax exemption to volunteer firefighters in the fire departments of Greenlawn and Centerport. The board wrote that it appreciates the service of the volunteers, but that the exemption would result in $52,271 “that would have to be borne by others in the community.”

Given the different stance that localities have taken on this issue, it is worthwhile to consider the question: Are tax breaks for volunteer emergency workers appropriate and fair? A proponent of tax relief might argue: "These volunteers make enormous sacrifices- they literally risk their lives- and giving them a tax break is a way of expressing our public gratitude for their sacrifices." No one would argue that these volunteers aren’t making a substantial contribution. But are tax breaks an appropriate form of recognition?

We admire volunteer firefighters and emergency workers because their actions go over and above a citizen’s call of duty. Some kind of public recognition is no doubt required. But monetary compensation, in the form of tax breaks, is arguably inappropriate and potentially unfair. The satisfaction of contributing without pay is part of the reason this work is rewarding for many volunteers. To offer what is effectively a salary is to reduce the most admirable characteristic of humans (benevolence) to the impoverished measure of value that already consumes society- money. The more significant the tax break is for such volunteer work the less it can plausibly be described as "volunteer" and the less prestige in the community this work will have.

Perhaps more important, the problem with granting such tax breaks is that such policies could potentially exacerbate existing injustices. The Harborfields school board clearly is concerned with this question: How will localities make up the loss in public revenue? This leads to more questions: Will extra tax-burdens be placed on citizens? If so, will this be done in a fair manner so the extra burden does not fall on those who already suffer economic hardships? If taxes will not be raised, then what will localities be willing to cut in order to offset the loss of public revenue?

It is one thing to say you support tax relief for volunteer emergency workers, but it is hypocritical to do so if you are not willing to subsidize such tax breaks out of your own pocket. To be fair across the board, tax breaks for volunteers must be made in conjunction with higher taxes on the more affluent, so that the rewards for volunteers do not also inflict unfair burdens on the vulnerable.

There are, of course, other possible arguments that are used to support tax breaks for volunteer emergency workers. Some make a pragmatic case that such tax breaks could help bolster lagging recruitment efforts. It would cost far more, this argument goes, if the locality is forced to replace the volunteer organizations with a paid force. The Greenlawn fire chief estimates, for example, that it would cost taxpayers $1.2 million to $1.4 million for one engine with five firefighters and one ambulance with two EMS workers, far more than the $52,271 tax break.

Faced with the choice between creating incentives to bolster volunteers or incurring the costs of a paid force, one might reasonably claim that tax breaks for volunteers are necessary. But that doesn’t necessarily make them fair. Why don’t we also give tax breaks to other dedicated volunteers who make admirable sacrifices that benefit our communities, such as literacy volunteers ? Fairness requires us to treat like cases alike, so is it fair to give tax breaks only for certain kinds of volunteer contributions and not others?

Fairness also requires us to consider the moral general question of why it is that localities face such a dilemma in the first place. When tax breaks are expected for voluntary sacrifice in service of the community, and the assumption is that a monetary reward is the only sign of sincere gratitude for civic contributions, one has to wonder whether there is a larger, more pressing, problem that we have failed to diagnose and address.

Thursday, September 11, 2008

p73 Gene and Alzheimer's Disease

The latest issue of Neuron has this study which reveals that missing a particular gene (p73) increases the risk of AD. The Globe and Mail has the scoop here. A sample:

Canadian scientists have discovered that a particular gene appears to be essential for protecting the brain as people age and that missing one copy may boost the likelihood of developing Alzheimer's disease or other neurodegenerative disorders.

In a study of genetically altered mice, researchers at Toronto's Hospital for Sick Children determined that mice with only one copy of the brain-protective p73 gene – instead of the normal two copies – exhibited the physical and behavioural traits of Alzheimer's disease.

The rodents' brains contained tangles, which are believed to clog up the pathways between brain cells, impairing their ability to learn and remember. The animals' co-ordination was also affected.

“Those mice when they were young seemed to be just the same as mice that had both copies of the gene,” said co-principal author Dr. David Kaplan, a senior scientist in the cell biology program at Sick Kids.

“But when we aged the mice to ages equivalent to older people, say over 65 years of age, then the mice with one copy of the p73 gene started to show all the hallmarks of a very aging, very old human brain,” Kaplan said Wednesday from Israel, where he was attending a research meeting.

And here is the abstract of the paper in Neuron:

The genetic mechanisms that regulate neurodegeneration are only poorly understood. We show that the loss of one allele of the p53 family member, p73, makes mice susceptible to neurodegeneration as a consequence of aging or Alzheimer's disease (AD). Behavioral analyses demonstrated that old, but not young, p73+/− mice displayed reduced motor and cognitive function, CNS atrophy, and neuronal degeneration. Unexpectedly, brains of aged p73+/− mice demonstrated dramatic accumulations of phospho-tau (P-tau)-positive filaments. Moreover, when crossed to a mouse model of AD expressing a mutant amyloid precursor protein, brains of these mice showed neuronal degeneration and early and robust formation of tangle-like structures containing P-tau. The increase in P-tau was likely mediated by JNK; in p73+/− neurons, the activity of the p73 target JNK was enhanced, and JNK regulated P-tau levels. Thus, p73 is essential for preventing neurodegeneration, and haploinsufficiency for p73 may be a susceptibility factor for AD and other neurodegenerative disorders.


Wednesday, September 10, 2008

"Big Bang" Machine

Today marks an important turning point in our quest to better understand the creation of the universe.

The £5 billion Large Hadron Collider (known as the "big bang" machine) should give scientists some key insights into what occurred immediately following the big bang that created the universe.

The Guardian has the scoop here, and CNN has a video here.


Monday, September 08, 2008

PGD Paper (Update)

Back in January of 2007 I posted this while on the train from Exeter to Oxford. A revised version of that paper has been accepted for publication in The Journal of Medicine and Philosophy. My earlier post outlines the central details of the arguments I advance in the paper. But here is an excerpt from the final paper:

What should the scope and limits of reproductive freedom be for citizens that live in pluralistic liberal democratic societies? And how can a philosopher help enhance our deliberations concerning what would constitute a fair and reasonable answer to such a contentious social question? These are the two general questions that motivate the analysis and arguments developed in this paper. But in order to make some progress towards answering these more general questions I will need to narrow the focus of this paper quite considerably....in this paper I will focus on a much more controversial range of issues, those which arise when considering permitting non-medical uses of PGD, such as gender selection. Gender selection (for non-medical purposes) is currently prohibited in both the United Kingdom and Canada.

....In this paper I will examine the appeal of these distinctive features of deliberative democracy (DD) by applying the theory to the issue of regulating the non-medical uses of PGD. PGD is perhaps an ideal issue to consider as it brings to the fore the two distinctive features of DD which Gutmann and Thompson (2004)emphasize. Firstly, it is a policy issue that raises distinct and conflicting values that need to be fairly accommodated. Permitting gender selection, for example, raises fundamental questions about the scope and limits of reproductive freedom and the importance of equality. And secondly, PGD is a novel technology that requires law-makers to adopt a provisionalist attitude. The stakes at risk in screening for gender, sexual orientation or a child’s propensity for certain behavioural characteristics can vary widely depending on the background features of the society in question (e.g. how pervasive patriarchy is) and the specifics of the intervention in question (e.g. costs of the procedure, etc.). Thus law-makers need to consider these different stakes and be prepared to revise policy in light of new moral insights and empirical discoveries.

By applying DD to the issue of regulating non-medical uses of PGD we see that the real challenge for liberal democracies, in terms of regulating these new technologies, is not to determine which first-order substantive or procedural values should be given primary importance. Rather the central issue is the different means by which we can best achieve a fair accommodation of the distinct values that arise in the context of regulating non-medical uses of PGD. So an examination of how DD can be applied to these issues illustrates how the theory can enhance public deliberation about legitimate public policy in a morally pluralistic liberal democracy. Rather than trying to win a philosophical debate among rival first-order theories, the prescriptions of DD will lead us to seriously entertain a certain range of policies over a different range of policies.

Drawing from the insights of DD, I argue that a just regulation of the non-medical uses of PGD is one that seeks to reasonably balance both substantive (e.g. liberty, equality) and procedural (e.g. democracy) values. Furthermore, it will seek to do so in a way that takes seriously what Gutmann and Thompson call “provisionality”. In order to take seriously the requirements of provisionality, as well as conflicting substantive and procedural principles, I argue that liberal societies should seek to satisfy what I call the Reasonable Genetic Intervention Model (hereafter referred to simply as the Model). The Model does not give an absolute priority to any one substantive or procedural principle; it adopts a cost-benefit analysis that permits liberal societies to consider the fuller range of values (e.g. ends) and issues (e.g. means) that must be addressed if we hope to justly regulate non-medical uses of PGD.

While I do not intend to utilize the Model for the purposes of pre-empting actual public debate on what constitutes a just regulation of PGD, I do conclude that outright bans or even severe restrictions on non-medical uses of PGD will likely fail the test prescribed by the Model. The general prescription of DD, as it applies to the issue of regulating PGD, is that justice requires that we pursue responsible legislative activism. Such activism does not give an absolute priority to considerations of liberty or equality, but it does require liberty-restricting provisions to be premised on grounds more defensible than mere speculations concerning the potential negative effects non-medical uses of PGD might have on society.


Thursday, September 04, 2008

Ord on Spontaneous Abortion

Last night at the RNC Mike Huckabee made this comment: "It is not above John McCain's pay grade to grasp the simple fact that human life begins at conception, and he is committed to protecting it".

Well let's accept, for the sake of argument, that it is a simple fact that human life does begin at conception. If one really, really accepts this premise (and I don't), then one's whole perception of the leading causes of human death, and the most important challenges facing all of humanity, ought to be profoundly altered. On this more expansive account of human life, the greatest threat to human life is not infectious disease, it is not poverty, it is not war or cancer or climate change. It is spontaneous abortion. More than 60% of all people are killed by spontaneous abortions, most of which occur in the first 8-10 days after conception. This amounts to 226 million embryos/people a year!

If we are to view these embryo loses as equal to the loss of actual human lives, then medical research to prevent spontaneous abortions should be the #1 priority of humanity (and the Republican Party). But of course that conclusion is ridiculous. And thus those who claim that their pay grade grasps the "simple fact" that human life begins at conception should put their money where their mouth is. Forget about the war on terror, the war against spontaneous abortion should be at the top of the Bush Administration's agenda.

Toby Ord has an excellent article on the topic of spontaneous abortion in the latest issue of AJOB. I wish every person who holds this "simple fact" would read his article. Here is a sample:

The argument then, is as follows. The embryo has the same moral status as an adult human (the Claim). Medical studies show that more than 60% of all people are killed by spontaneous abortion (a biological fact). Therefore, spontaneous abortion is one of the most serious problems facing humanity, and we must do our utmost to investigate ways of preventing this death—even if this is to the detriment of other pressing issues (the Conclusion).

....These numbers show that spontaneous abortion is an everyday phenomenon. A mother of three children could be expected to have also had approximately five spontaneous abortions. An embryo’s survival to term is the exception rather than the norm.

It might seem surprising that these dramatic death rates for early embryos could remain unknown to the general public. However, the reason for this is that most embryo loss occurs before the pregnancy has been detected, and the woman is unaware that anything out of the ordinary has happened. The embryo simply passes out of the uterus with the next menses.

....In 6 years, the Second World War killed approximately 60 million people, whereas
spontaneous abortion kills more than three times this number every year. For supporters of the Claim there is little choice but to see it as one of the world’s greatest problems, if not the greatest problem.

Ord's article is required reading for all those who claim that the "life begins at conception" premise is "within their pay grade"!


Wednesday, September 03, 2008

Bioethics Paper on Equality and Retarding Aging

Following on from my previous post on our aversion to inequality... One inequality that I believe we should have an aversion to is the inequality in health prospects that exists between the young and the aged. And thus longevity science should be something which egalitarians champion as an important and innovative strategy for combating these unchosen inequalities.

Why should the aged have a much greater risk of cancer, heart disease, diabetes, AD, infection and death? The aged do not deserve the cellular and molecular damage that accrues over time; and thus we should seek to mitigate these vulnerabilities. And so I think the aspiration to retard human aging is actually a requirement, not violation, of equality. And this is what I argue at greater length in my paper "Equality and the Duty to Retard Human Aging" which has been accepted for publication in the journal Bioethics. Here is a sample from that forthcoming paper:

Not all species age the same way. The maximal lifespan of mice, for example, is only a fraction of the maximal lifespan of monkeys and turtles. And even within a species there is some variation among the rate of aging. “The tiny chihuahua can live 12–15 years compared to six or seven for its larger cousin, the Irish Wolfhound”. And while it is true that every human being celebrates a new birthday each year, the lifelong accumulation of molecular and cellular damage we experience with the passage of time can vary dramatically. It is possible for some humans to reach the age of 100 years old free from the diseases (e.g. cancer, heart disease, diabetes) that kill most of their contemporaries decades earlier. Approximately 1 in 10 000 Americans are centenarians. And recent studies of centenarians and the impact of “longevity genes” suggests that there is a significant genetic component at play. Having a centenarian sibling increases one’s chances of survival to very old age. Furthermore, one recent study found that the offspring of long-lived parents had significantly lower prevalence of hypertension (by 23%), diabetes mellitus (by 50%), heart attacks (by 60%), and strokes (no events reported) than several age-matched control groups.

A number of biogerontologists, philosophers and policy advocates have begun to engage in a spirited debate concerning the priority of tackling human aging itself. And this paper seeks to add a new dimension to these debates by placing the duty to retard human aging within the framework of a theory of just healthcare. In particular, I consider two prominent theories which emphasis a principle of equality. Norman Daniels invokes the principle of fair equality of opportunity to outline an account of just healthcare that places great emphasis on the notion of “normal species functioning” and the treatment/enhancement distinction. Ronald Dworkin’s account of equality of resources emphasizes the importance of mitigating brute luck inequalities; that is, inequalities that people are not responsible for. Dworkin invokes the idea of a hypothetical insurance scheme to determine the range of medical provisions that should be provided by the publicly funded health care system.

I consider what both of these accounts of equality would say about the duty to retard human aging and conclude that both accounts of equality, once suitably amended and revised, actually support the conclusion that anti-aging research is important and could lead to interventions that ought to be considered “medical necessities”. Examining the relation between equality and anti-aging research should help enhance the interdisciplinary debate and engagement that is needed to ensure that philosophers, bioethicists, gerontologists and policy makers address the duty to retard human aging in a fair and proportionate manner.

....To remain faithful to the idea that normal species functioning provides a natural baseline for medical services, and yet to also spend billions trying to treat all of the various age-related disadvantages that we are susceptible to, is to be pulled in two contradictory directions. And the result is a sub-optimal and unfair response to our biological vulnerabilities. The current mindset will have dire consequences for societies (like the United States) that are set to have unprecedented numbers of senior citizens in the decades to come. To help us respond, in a fair and proportionate manner, to age-related disadvantage we must transcend the narrow limitations imposed by the notion of “normal species functioning” and the treatment/enhancement distinction.

A revisionist reading of Daniels’s account of fair equality of opportunity and just healthcare is one that will give primary importance to the impact aging has on the range of opportunities open to us...

....Once we add aging into Dworkin’s tale [of the hypothetical auction and insurance scheme] we see that aging itself can give rise to complaints that violate the envy test. Those who are more susceptible to infection, disease and frailty- like the aged- will envy the health prospects of the youthful and this inequality is unchosen. Furthermore, the age-related disadvantages that shall be visited upon the aged violate the requirements of the principle of equal importance. That principle stipulates that “human lives be successful rather than wasted, and this is equally important, from an objective point of view, for each human life”. Pathology, pain and suffering, these all compromise the success of a human live by limiting our ability to pursue our conception of the good and, ultimately, by ending our lives completely. The principle of equal importance does not say that human lives should be successful only for a fixed number of years, after which point people’s interests in remaining healthy have no ethical significance. And thus one ought, to be consistent with the logic of luck egalitarianism and the principle of equal importance, bring to the fore the importance of redressing age-related disadvantage.

....I conclude this paper with one final thought. Egalitarians might be tempted to complain that my analysis misses the mark. It does so, they might argue, because the primary egalitarian concern is that if anti-aging interventions should one day become possible this would exacerbate existing inequalities as only the rich would be able to afford to pay for them. This is a serious concern. However, the arguments I have developed in this paper are an attempt to ensure that we do not arrive at this situation. But showing how equality requires us to tackle aging I have sought to make a compelling case for investing, with public funds, in the science of anti-aging research. If we do this, and do it now, we are less likely to face the situation the egalitarian is concerned about. For that scenario is much more likely to occur if anti-aging interventions are not viewed as important medical necessities. In that kind of scenario not only will it take longer for such interventions to come into existence, but such research will be forced to rely very heavily on private funding. And this could have adverse effects on how widely available such interventions are. So the greatest threat anti-aging research is likely to have on equality would occur when such interventions are viewed as falling outside the scope of “medical necessities”. And thus it is imperative that we begin to have an informed, robust moral discourse on the importance of anti-aging research and its relation to equality and just healthcare.


Monday, September 01, 2008

Nature Article on Inequality Aversion in Children

The latest issue of Nature has an interesting article which should be of interest to political philosophers (especially egalitarians). It's titled "Egalitarianism in Young Children" by Ernst Fehr, Helen Bernhard and Bettina Rockenbach, and it examines the other-regarding preferences of young children. Of particular note is the role parochialism plays in such preferences. Here is the abstract:

Human social interaction is strongly shaped by other-regarding preferences, that is, a concern for the welfare of others. These preferences are important for a unique aspect of human sociality—large scale cooperation with genetic strangers—but little is known about their developmental roots. Here we show that young children's other-regarding preferences assume a particular form, inequality aversion that develops strongly between the ages of 3 and 8. At age 3–4, the overwhelming majority of children behave selfishly, whereas most children at age 7–8 prefer resource allocations that remove advantageous or disadvantageous inequality. Moreover, inequality aversion is strongly shaped by parochialism, a preference for favouring the members of one's own social group. These results indicate that human egalitarianism and parochialism have deep developmental roots, and the simultaneous emergence of altruistic sharing and parochialism during childhood is intriguing in view of recent evolutionary theories which predict that the same evolutionary process jointly drives both human altruism and parochialism.