Sarah Palin’s Record as Mayor: Teeny Tiny Bush Administration

September 2, 2008

This is a truly startling little read, from one of Sarah Palin’s old constituents as Alaskan Mayor.

If she’s to be believed then Palin’s mayoral reign over the tiny town of Wasilla should sound startlingly familiar to anyone who’s watched the last 8 years of the Bush Administration deeply politicized mismanagement.

She fired experienced public servants because they won’t bow to bizarre ideology: including a librarian who refused to ban books Palin didn’t like. She sliced progressive taxes on the rich, raising regressive ones on the poor, and then spent lavishly: leaving the town in newfound debt. She hired a lobbyist who scored the tiny town almost 27million in federal pork. And in the face of management squabbles, she seems to have handed off the actual day to day administration to another person.

Pile this record on top of her support for ignorance-only sex education, creationist-seasoned science-classes, and a hearty round of theocratized historical ignorance and Christianist knee slappers and she sounds like the second coming of the Mayberry Machiavellis.

I’ve had a hard time getting too worked up about the thought of a McCain administration, but the idea of a Sarah Palin taking over wherever he finally leaves off is sounding less and less encouraging. Bush has gotten a worse rap than he deserves. Even still, I’m not eager to spend the next four to eight years sapping my forehead in everything from wearied exasperation to shock.


McCain Picks Sarah Palin as VP… Analysis

August 29, 2008

Palin has landed? If so, it looks like I was right about McCain’s strategy in VP picks. It only remains to be seen whether or not Obama’s failure to anticipate, or at least pro-actively counter, this move will cost him in the way I expect.

When it comes to message, Palin ironically seems to undercut virtually every major line of criticism the McCain camp has so-far employed against Obama. Palin was a former beauty-pageant contestant: surely the crown jewel of the “vapid celebrity” image. Palin has little political experience (undercutting McCain’s claims of similar worries about Obama) and an abuse-of-power scandal under her belt (playing into the “3rd term for Bush” narrative). But the sort of people who buy into these sorts of character narratives are notoriously immune to hypocrisy, and even if they weren’t, what really McCain needs more than anything else is something that will shake up the race big time and keep the “bitter Hillary supporters” narrative in play. Palin fits the bill.

While Palin isn’t actually the first woman to be a Vice-Presidential nominee, that actually matters far less than the possibility that she could be the first woman to become Vice-President, and with her on the ticket, some measure of Obama’s uniquely historic appeal of a “first” is definitively blunted.

Like I said previously: this is a savvy move, and one that Obama’s camp had every opportunity to strangle in the crib. Either they don’t think it will play out in McCain’s favor, or they think that Biden will have some advantage that I’ve yet to see myself. Palin is also as right-wing as they come on social issues, completing McCain’s own retreat from his former life as a maverick and near-independent.


Conscience For Me But Not For Thee: The Case for Pro-Life Docs and Pharmacists

August 22, 2008

In two recent threads over at Pharyngula, one about a poll and the other about some recent comments from HHS Secretary Mike Leavitt, I’ve gotten myself caught up in some pretty heated exchanges over the issue of pro-life doctors, and their impact on reproductive choice and access to health care.

This controversy has been building for some time, as legislatures and now licensing boards are increasingly confronting the question of whether, and to what degree, the consciences of anti-abortion doctors should be protected. More and more women are startled to find local doctors and pharmacists refusing what they had assumed were basic and perfectly legal prescriptions.

Now, as far as the original issues go, most of the things that anti-abortion docs, pharmacists, and their advocates are currently pushing for are indeed overboard. The idea that a doctor can refuse to refer a patient to another doctor, or refuse to even give them information, is unjustifiable. And if a CVS pharmacy wants to offer the pill to its customers, then it has all the cause in the world to only hire and retain staff that are willing to dispense it. It’s simply not unjust discrimination to fire someone if their conscience prevents them from doing what the employer needs done, and no reasonable (reasonable on the employer’s terms) accommodation can be found.

Unfortunately, many of my pro-choice compatriots have, I think the wrong idea themselves, asserting principles of their own that go far beyond the right of employers to set the conditions of employment. When it comes down to it, it seems that many people believe that doctors who refuse on ethical and/or religious grounds to prescribe birth control pills, pharmacists that refuse to fill such orders, or even, it seems ob/gyns that resist performing elective abortions should either ignore their consciences or essentially leave their chosen professions. But the justifications given for this harsh ultimatum are, I think fatally flawed.

Two principles in particular are, I think twisted or misapplied to this situation: the idea that pro-life doctors are forcing things on their patients, and the idea that pro-life doctors and pharmacists aren’t doing “their job.”

Doctors Have No Right To Force Their Choices on People

As general principle, this idea Is central to most cannons of medical ethics and medical license boards. And justly so. It’s based, first and foremost, on the idea that people of sound mind have an absolute right to accept or refuse medical care, and to pick the treatment plans they are comfortable with under the advice of the physician. It’s based on a laudable ethic of not forcing something on someone without their consent.

The problem is that this ethic seems to fall by the wayside whenever people start considering the views of people they don’t like. Or it gets implausibly twisted, so that the “forcees” are claiming to be the victims. It takes a true mangling of language to assert that someone not doing something for you constitutes forcing you to do anything. But that appears to be precisely what it going on here.

Consider the common assertion that doctors who refuse to prescribe birth control, especially when they practice in far-flung areas and stats that offer little choice in doctors to begin with, are “forcing” their own preachy choices on the patient. But are they?

When a family doctor sets up a shingle in a small town, people’s access to health care improves in real terms. But now suppose that the doctor refuses to prescribe birth control or perform elective abortions. Has the doctor actually “forced” anything on anyone? His or her values? His or her services?

In virtually all routine situations, no. The people in the town are certainly no worse off than they were before the doctor arrived. The doctor’s existence provides some benefits, but perhaps not all the benefits they’d want. Demand that the doctor violate his or her conscience or else find another profession, and you might well end up with no nearby doctor at all. The same goes for a hypothetical “pro-life” pharmacy.

Yes, people in that situation lack access to things they want and need, and are protected by law. But that’s the exact same situation they were in before the anti-abortion/anti-pill doctor set up shop.

So what’s the solution? Well, if we really care about access to birth control, if that’s really something we consider to be a moral value or even an assured, positive right, who has the responsibility to supply it? Does that responsibility fall almost entirely on the doctor who thinks it’s immoral, just because he happens to be the most local? Or does it fall on all the people who think it’s a basic right? If you answered the former, I have to admit that I’m simply flabbergasted.

The situation here is a little like the often confused outrage at “scalpers” who, during a disaster, offer things like water bottles for sale at ridiculously inflated prices. These people are routinely condemned as greedy, and they certainly are. But somehow it never occurs to all these outraged moralists that, if people in a disaster have some sort of positive right to receive water (free or cheaply), that this right cannot possibly be a burden and a responsibility that falls on some people more than others. At least the scalpers are offering water for sale at all. Rarely have any of the outraged people rushed over to offer even a drop of their own water, at any price. If the scalpers are as greedy as their inflated prices, then the moralists shaking their heads are themselves infinitely greedier.

Blaming the scalpers for a lack of available water, or blaming pro-life doctors for lack of available abortion services and birth control, is, in the end, nothing more than crude scapegoating. It takes the focus, rather conveniently I might add, off of the collective failure for which the moralists themselves are implicated.

And the further irony is that the moralists’ proposed solutions often wouldn’t really help anyone overall. Scalping only works when there is an extremely limited water supply: i.e. there’s too little water to go around in the first place. If scalpers simply gave away all their supplies for free, there would still be too little water: in fact, in the end, there would be exactly the same number of people with and without water. All that would be different is the method by which these people would be chosen (and the usual alternative, first come=first serve, is arguably no more “fair” than rationing the supply by price, which at least has some built in mechanism for assessing people’s relative need for the water).

Likewise, if anti-abortion/anti-pill physicians and pharmacies left the business, as their foes seem to suggest they should, there would still be the same shortage of medical care and lack of access to birth control that we started with.

From where I sit, that makes this issue look a heck of a lot more like an act of partisan revenge than a sound policy or pro-patient principle.

If They Don’t Want to Do What (I Say) the Job Entails, They Should Find Another Job!

This second principle, uttered as if it were an obvious truism, is in fact an utterly bizarre essentialism. Obviously, if we are talking about an employer defining what “the job entails” and finding someone wanting, there’s no problem. But this isn’t the sense in which some people mean “the job.” They mean it in a more cosmic sense: turning mere convention into Platonic form.

Who says that the role of being an ob/gyn, a family doc, or a pharmacist must involve prescribing or dispensing contraceptives? What defines that role such that it’s supposedly essential to this or that specialty? Is this some sort of immutable law of the universe? No. To the extent that they are set and regulated at all, the required roles of various professions (and the permitted variations) are set by committee or political process, not fate. And those debates have to deal with the very political and ethical questions we’re already considering.

Thus, asserting that elective birth control must be part of the role of certain doctors is little more than a begged question. If you regard a fetus or even a fertilized embryo to be a being with moral rights, then harming it without dire need would not legitimately be part of the role of any physician. Reject that idea, and it’s a legitimate part of reproductive health and choice. I certainly have my opinions, but I also have a respect for the importance of social pluralism. And we cannot simply presume anyone’s opinion from the get go when determining what medical ethics demand or deny.

A more reasonable question is: can anti-abortion doctors be reasonably accommodated into our medical system with their existence causing serious additional harm to anyone? I think the answer is yes.

My opponents disagree. They imagine Jehovah’s Witnesses as ER docs who then refuse to transfuse blood to car accident victims. But these examples are absurd. No one would hire such a doctor to such a position in the first place, and if one did, it’s unlikely it could be licensed to accept emergency patients (who are often in a very different situation than a person seeking a physician or going to a pharmacy). On the other hand, plenty of people in the United States not only would have no problem with seeing an anti-abortion ob/gyn, but would favor going to one. Is denying the possibility of this choice even in keeping with the respect for autonomy that underlies pro-choice politics in the first place? I think not.

The early pioneers of reproductive choice knew that making it a reality meant actually physically and financially getting doctors and products out to women everywhere. If choice is a positive right and not just a negative one (i.e. not merely something that the government cannot ban, but something that must actively be ensured, presumably by society itself) then it’s going to take a tall order of money, time, and resources to supply it. Butting heads with anti-abortion doctors and pharmacists, or demanding they conform or go out of business, isn’t even remotely the same thing.


Miracles and Medical Care

August 18, 2008

Via CNN comes this story detailing the ways in which people’s religious faith and belief in otherworldly intervention colors the way they deal with medical care. This issue raises some really hard questions when it comes to dealing with religion vs. science, belief vs. the lack of it. Take this case:

Pat Loder, a Milford, Michigan, woman whose two young children were killed in a 1991 car crash, said she clung to a belief that God would intervene when things looked hopeless.

“When you’re a parent and you’re standing over the body of your child who you think is dying … you have to have that” belief, Loder said.

Do you though? And does it really help in the long run to truly believe things like that?

We often imagine that these sorts of ideas are obviously comforting, but in my experience, the evidence is decidedly mixed. Unrealistic expectations can lead to bitterness. They can stall acceptance and take you out of a situation right when loved ones need you the most.

And in some ways, these sort of “comforting beliefs” don’t necessarily seem to bring the comfort they would logically imply. Heaven, objectively, should be an absolutely comforting idea that essentially solves the fear of death and heals all hurts. But in practice, the human psyche just seems to grieve no matter what one believes: beliefs are errant trivialities don’t really reach down into the deep, animal well of loss.

On the other hand, these sorts of reactions are, for many people, unavoidable. They can’t really be fought or regulated or even argued with.

The other issue here is that of the way a belief in miracles distorts people’s medical decisions, making them postpone taking loved ones off futile life support, and in countless cases, continuing pointless treatments when comfort, hospice, and simply preparing for death are more important.

It is true that there are occasional cases of so called medical miracles (though rarely are they without explanation and underlying causality). But as the CNN survey shows, beliefs about medical miracles are sort of like people playing the lottery: extremely unlikely occurrences are coloring and altering the decisions of masses that are, in the aggregate, probably not worth it. Should an incredibly unlikely, 1 in a million chance that someone who has been coded for hours will come back with any sort of brain function at all really be a gamble worth, well, millions of other futile medical efforts that only traumatize the family, cost millions more (that could be used instead to save the more likely savable), and sometimes even just make a patients final moments all the more agonizing? Probably not.

The problem is simply that its very easy to see futility in the aggregate, where likely outcomes seem inevitable, but simply not accept it in specific, where ideas of heroic salvation and turning a corner can never be fully dismissed.

And that’s sort of the bizarre part. If miracles could really happen, intentional miracles directed by a being like God, then it hardly seems to make sense to debate whether or not to keep someone on life support indefinitely. An all powerful being would be able to work its miracle on a person no matter what amount of medical care had been given or withheld. The idea, indeed, of “waiting” for a miracle, as if to give it more chances to happen, seems, in the context of a theism than envisions and all-knowing, all powerful God, utterly bizarre.

Update: Here’s an all too common outcome of many heralded medical miracles: while unexpected persistence can surprise, it just drags out the inevitable further, as with this premie who appeared to rally after being declared dead and then chilled (which slowed its remaining metabolism, only to die for real a day later.


Church Killer Adkisson’s Reading List: O’Reily, Hannity, Savage

July 29, 2008

A few more details coming out about what Mr. Adkisson thought he was doing by showing up at a Unitarian church and opening fire with a shotgun.

According to the Knoxville police, Adkisson’s writings expressed that he believed the church was a legitimate target “because of its liberal teachings and his belief that all liberals should be killed because they were ruining the country, and that he felt that the Democrats had tied his country’s hands in the war on terror and they had ruined every institution in America with the aid of major media outlets.”

The church apparently was once attended by his ex-wife at one point, where she no doubt was thought to have picked up or practiced many of the ideas that Adkisson found so detestable. And the Washington Post’s “On Faith” has more on his obsessions:

Adkisson, who had served in the military, said “that because he could not get to the leaders of the liberal movement he would then target those that had voted them in office,” the search warrant states. Among the items seized from Adkisson’s house were three books: “The O’Reilly Factor,” by television commentator Bill O’Reilly; “Liberalism is a Mental Disorder,” by radio personality Michael Savage; and “Let Freedom Ring,” by political pundit Sean Hannity.

All three of these books are, of course, over-the-top, take-no-prisoners partisan screeds. I don’t want to endorse the idea that these writers caused Adkisson to do what he did. But all three of them are books that a madman who hates liberals would find much resonance and comfort in, and nothing to make him think twice.

They don’t counsel thoughtful realism. They don’t endorse moderation or skepticism in their condemnations. They don’t really even acknowledge that liberals might be sincerely mistaken: they instead paint pictures of near-perfect perfidy, depravity, and treason that are destroying and undermining every principle of good society. If you take everything they say seriously (something I don’t think any of those authors actually do themselves), then it’s not hard to see how one could conclude that the stakes are high, and the enemy unredeemable.

None of them endorse mass murder, of course, and so these authors can legitimately disavow any responsibility for what Adkisson, and Adkisson alone, decided to do. But at least off camera, I hope these authors feel at least a tiny bit of regret for a missed opportunity. At one point, they had his attention, and yet so thoroughly failed to make him think twice about his hatreds.

Instead, they simply gave him a tune to sing along with in his desperation. Nothing but reinforcement in his obsessive belief that all the evils in his life stemmed from a single source. For these authors, the grossly uncharitable and uncompromising rhetoric of political shock-jockery was at least partly just theater. Rants that just sounded too good, and were too effective as political spin, to be slowed down with caveats or compromise.

But, unfortunately, at least one person wasn’t in on the joke.


Anti-Evolution Doc Expelled Really Is Trying for a Theatrical Comeback!

July 19, 2008

Looks like those vague hints and rumors were indeed authentic: Ben Stein’s anti-science opus Expelled is going to be re-released later this summer.

The rationale, however, strikes be as pure hype:

“We had many individuals and groups who had planned to see the film, but decided not to because the cloud of doubt this lawsuit brought to the film,” noted one of the film’s producers, John Sullivan.

Riiiiight. Because an obscure lawsuit based on copyright claims that few people outside of nuts like myself that follow these things ever heard about had a chilling effect on ordinary moviegoers.

Now, it might have been reasonable for Sullivan to note that the Ono lawsuit hurt the distribution efforts of the film, which it almost certainly did, and that this hurt their momentum.

But this production has always favored incoherently overwrought rhetoric over honest appraisal. Does Sullivan really expect anyone to seriously believe that any moviegoers at all avoided the film because of the lawsuit? Were they afraid that Ono would have thugs stationed outside the theaters threatening anyone who dared to watch it? Conflicted fans of both the Beatles and Ben Stein that held off declaring their allegiances until the legal issues were resolved?

“We came out of the gate with strong momentum only to have our integrity questioned by this frivolous lawsuit. While we’re thrilled with the film’s having earned nearly $8 million during its first run; we’ve heard from enough people and groups who want to see it in their theaters that we’ve agreed to re-release it this time without an undeserved cloud over its head.”

Because, of course, the only “cloud” over the film’s head was an obscure copyright lawsuit and not, well, you know, most critics panning it, sciencebloggers raking it over the coals for its distortions and slander, the ADL condemning it, and so on.

And this paragraph makes the “cloud” reasoning even more ridiculous. People obsessive enough to demand the immediate re-screening of a film which will likely be out on DVD in a few months are not the sort of people who would have stayed away the first time… based on the mere existence of a copyright lawsuit against the film.

“We will not be silenced. In fact it will have the opposite effect: we will re-release it and allow millions of Americans to go to the box office and register their vote against Ms. Ono and her attempt to keep them from watching our film.”

As John Pieret has pointed out, something is funky with the math here. Given that Expelled made about 7.5 million during its run, and ticket prices were generally in the range of 8 dollars and up, then at best the film got about a million viewers (not counting the fact that some percentage of people would have been repeats). The odds are astronomically low that any hypothetical second run would match that, let alone exceed it.

And indeed, despite all the hype, it looks like the producers know that, and that the “re-release” is not quite akin to a remastered Star Wars. At the end of the article, they note that they have 1000 prints of the film ready to go. Which is a rather far cry from “1000 different theaters already booked to show the film”: the sort of thing you might expect from an announcement about an impending re-release. As far as I can tell, this is all just hyperbolic way of announcing that the producers, free from the injunction, are now willing to lease out old prints to anyone who wants them.

Which all strikes me as sort of pathetic coming from an outfit that once seemed to sincerely believe that they would be sparking off a vast nationwide movement. We still don’t know whether the filmmakers actually broke even after their production and marketing costs.


Obama Against “Mental” Exceptions to Late-Term Abortion Bans

July 4, 2008

Obama’s stance on abortion is pretty much in the mainstream of the Democratic Party, but with one critical difference when it comes to late-term abortions (i.e. abortions post fetal viability). And, luckily, for him, it’s precisely the exception I would make. Obama doesn’t think that “mental distress” should qualify as an exception to bans on late term abortions. This position puts him at odds with pro-abortion rights groups and members of his own party.

Still, I think it’s the right one. Anti-abortion groups have a legitimate fear that sufficiently vague “mental” health exceptions could undermine the point of the ban entirely: any person can develop “tremendous emotional toll” even from a normal pregnancy. But that really doesn’t fall under the same situation as health exceptions in general, and in practice, this exception can basically serve as an end-run around the ban. Groups like NARAL, of course, paint things differently:

The official position of NARAL Pro-Choice America, the abortion rights group that endorsed Obama in May, states: “A health exception must also account for the mental health problems that may occur in pregnancy. Severe fetal anomalies, for example, can exact a tremendous emotional toll on a pregnant woman and her family.”

This is yet another situation in which I wish people on both sides of the abortion divide would just express what they actually mean: what specific conditions is NARAL talking about? Conditions like anencephaly, where the brain essentially has not formed properly, and the baby has no higher brain function and no chance of survival beyond a few weeks? (I’m in favor of allowing abortion in such cases) Or does it mean Down’s Syndrome, a missing arm, or a partially malformed gut? All of the latter could be called “severe anomalies,” but such babies are essentially normal in terms of their capacity to feel and suffer. (I’m against abortion in such cases) The details matter.

In any case, while he’s sure to take fire from liberals on this, Obama has about as much chance of getting any honest credit for his stance as the New York Mets do of winning the Superbowl. Anti-abortion groups are, of course, having none of it:

David N. O’Steen, the executive director of National Right to Life, said Obama’s remarks to the magazine “are either quite disingenuous or they reflect that Obama does not know what he is talking about.”

“You cannot believe that abortion should not be allowed for mental health reasons and support Roe v Wade,” O’Steen said.

O’Steen is technically right here: a companion case to Roe was Doe v. Bolton, which defined “health” exceptions very broadly, including considerations of “emotional, psychological, familial” factors. But O’Steen is still essentially dissembling: the definition, while broad, is also vague enough that someone like Obama could reasonably believe that those other factors could almost never, on their own, justify an exception.

O’Steen, of course, has no reason to be charitable and honest in how he portrays Obama. Even if Obama really is closer to his own stance on this issue (which he already has a decent reason to doubt), Obama’s party taking power in the White House is far far more important to his chosen issue (outlawing abortion) than giving him credit for a minor agreement and risking rank-n-file anti-abortion voters potentially seeing Obama more favorably.