Month: March 2014

by Patrick Appel

David Blumenthal explains why the health care industry hasn’t embraced digital medical records:

The reason why the medical profession has been so slow to adopt technology at the point of contact with patients is that there is an asymmetry of benefits. From the patient’s perspective, this is a no-brainer. The benefits are substantial. But from the provider’s perspective, there are substantial costs in setting up and using the systems.

Until now, providers haven’t recovered those costs, either in payment or in increased satisfaction, or in any other way. Ultimately, there are of course benefits to the professional as well. It’s beyond question that you become a better physician, a better nurse, a better manager when you have the digital data at your fingertips. But the costs are considerable, and they have fallen on people who have no economic incentive to make the transition. The benefits of a more efficient practice largely accrue to people paying the bills. The way economists would describe this is that the medical marketplace is broken.

Richard Gunderman provides another perspective:

[Dr. Paul] Weygandt [a VP at a medical communications firm] believes that contemporary medicine has allowed too many intermediaries—financing, technology, and the way practices are structured—to come between patients and doctors. Too much time is focused on generating revenue rather than quality. Too many technological systems are built in ways that make sense to computer engineers but not to doctors. And too much time is spent pointing and clicking rather than capturing the essence of a patient’s story.

What can be done? Weygandt argues that doctors need to play a more active role in all aspects of healthcare’s future, not just implementing but also designing it. Too often, such decisions are currently being made by people who do not take care of patients, and in many cases, have never cared for patients.

by Jessie Roberts

Ross Andersen interviewed philosopher Rebecca Roache about how life-extending technologies may come to be applied to prisoners:

Suppose we eventually learn to put off death indefinitely, and that we extend this treatment to prisoners. Is there any crime that would justify eternal imprisonment? Take Hitler as a test case. Say the Soviets had gotten to the bunker before he killed himself, and say capital punishment was out of the question – would we have put him behind bars forever?

Roache: It’s tough to say. If you start out with the premise that a punishment should be proportional to the crime, it’s difficult to think of a crime that could justify eternal imprisonment. You could imagine giving Hitler one term of life imprisonment for every person killed in the Second World War. That would make for quite a long sentence, but it would still be finite. The endangerment of mankind as a whole might qualify as a sufficiently serious crime to warrant it. As you know, a great deal of the research we do here at the Oxford Martin School concerns existential risk. Suppose there was some physics experiment that stood a decent chance of generating a black hole that could destroy the planet and all future generations. If someone deliberately set up an experiment like that, I could see that being the kind of supercrime that would justify an eternal sentence.

Ari N. Schulman criticizes Roache for raising concerns about future uses of biotech without sufficiently addressing reasons not to pursue the technology:

It’s the same from doping the populace to be more moral, to shrinking people so they’ll emit less carbon, to “after-birth abortion,” and on on: Imagine some of the most coercive and terrible things we could do with biotech, offer all the arguments for why we should and pretty much none for why we shouldn’t, make it sound like this would be technically straightforward, predictable, and controllable once a few advances are in place, and finally claim that you’re just being neutral and academically disinterested; that, like Glenn Beck on birth certificates, you’re just asking questions, because after all, someone will, and better it be us Thoughtful folks who take the lead on Managing This Responsibly, or else someone might try something crazy. …

[W]hen transhumanists claim to be responsibly shining a light on a hidden path down which we might otherwise blindly stumble, what they’re really after is focusing us so intently on this path that we forget we could yet still take another.

by Chris Bodenner

A reader presumes wrong:

I highly doubt this post will become a thread, as so many other weighty topics have done. But I am willing to admit that I have never – in my 60 years of life – ever successfully deployed a paper toilet-seat cover! Either I’m in way too much of a hurry to bother, or the stupid thing tears coming out of the dispenser or while I’m trying to gently unfold it and ease out the center “hole” section. Or I do get it properly placed and then, just as I lower myself down, half of it slips into the toilet. I long ago gave up f-ing with the covers at all. Glad to know I’m not really taking my life in my hands!

Another sees an opening:

I greatly enjoy your blog, but this is the first time I’ve been inspired to write. This thread reminds me of one of my family’s favorite stories.

First, some background: my grandmother was a long-time public advocate for comprehensive sex education and reproductive health, partly during her work for the California’s women’s correctional programs. She was also not known for blunting her speech when a direct approach would do. One day, following a speech on sex education, a nun in the audience stood up to ask if someone could “catch an STD from a toilet seat?”

“Only if you fuck it while it’s still warm, Sister.”

Another conveys the ick factor felt by many readers:

I don’t use toilet-seat covers because I fear STIs; it’s because of icky, dirty seats. Unisex bathrooms where guys with bad aim don’t put the seat up beforehand. Little kids sliding off the seat after a poop. That well-soaked tampon whacking the seat during removal. And don’t even get me started on the vomit. Eew.

Another raises a much bigger issue:

It should be noted that the notion of contracting an STI from public toilets was developed as a means to explain venereal diseases in children before medical professionals and others were willing to entertain the idea that the children were being sexually assaulted by family members or other adults. It’s important to remember that these things happen, are happening and that our historical impulse has been to refuse to listen to the victims and survivors.

by Patrick Appel

Matt Sigl calls Fred Phelps “a great friend to the gay rights movement”:

In his outrageous lunacy, his relentless desire for media attention, and the purity of his hatefulness, Phelps did something that the gay rights movement couldn’t accomplish on its own: expose the utter depravity and heartlessness of homophobia. … Phelps probably secretly troubled the pious and faithful more than he ever got underneath any homosexual’s skin, for in him the conservative Christian had to confront just what God really thought of homosexuals after all. The subject is not a pleasant one for many leading religious leaders; just watch the milquetoast Joel Osteen wince when forced to comment on it. Or Cardinal Dolan for that matter.

Alyssa Rosenberg is on the same page:

[A]s the gay rights movement has worked to define lesbian, gay, and bisexual Americans as people who want the same things as their heterosexual counterparts, including marriage and family stability, Fred Phelps and his followers gave organizers a perfect image to organize in opposition to. If Americans had to choose between getting comfortable with the idea of homosexuality or being seen as extreme, hateful, and rude, in increasing numbers, they seem to be choosing the former. Fred Phelps has caused many people enormous amounts of agony. But in doing so, he played a critical role in defining the choice between hatred and acceptance, and in accidentally expanding the tolerance of the very people he feared so much.

Jay Michaelson adds:

As symbol, Phelps was the reductio ad absurdum of many conservative beliefs. Tea Partiers think Obama is a socialist, Birthers think he’s a Kenyan, and Phelps said he was the antichrist. Tea Partiers think America has lost its way, Glenn Beck thinks it’s time for revolution, and Phelps said America will be destroyed by God for losing its moral grounding.

Erica Cook is against cheering Phelps’s death:

This is the chance to show the world how we are better people. We aren’t people who make the death of a man the reason to celebrate, no matter who that man is. We are the better people. And no matter who he is to us, he was someone’s father, grandfather, brother, and uncle. We may still be fighting against them, but today they need the respect they didn’t have the capacity to give when it was us. If we act in any way other than respectful we become no better than them. In stooping to that we relinquish the right to call what they do wrong.

Russell Saunders is declares to “hell with all that”:

Fred Phelps was a blight.  He was a receptacle for the absolute worst, most despicable kind of hatred humanity is capable of producing.  The god of his imagining was a demon of bile, and his appearance before the public eye was a festering sore.

I do not regret the happiness I feel knowing I no longer share an oxygen supply with him.  I do not believe in the existence of a hell, even for the likes of people like him.  If there is a judgment that awaits him, let his loved ones hope it is before a judge more merciful than the one he worshiped.

Richard Kim unpacks Phelps’s worldview:

Especially in recent years, he possessed almost no followers, no influence, no allies. What distinguishes him from any other raving street-corner prophet is the simple-mindedness of his message. In the place of the modern religious emphasis on God’s love, Phelps ranted on about God’s hate—for fags, for America, for Muslims, for Catholics, gun massacre victims and US troops. If American exceptionalism is in some way an attempt to sacralize the profane (America is blessed, its soliders and citizens blessed), Phelps merely reversed polarities, swapping in eternal damnation. It was a juvenile substitution. And to discuss Phelps as if he were a morally vexing and profound evil is to dignify him with a complexity he lacked. His hatred was banal.

Tom Junod met the Westboro Baptist Church clan once:

I don’t remember anything they said. What I do remember was how their children looked, and the keen and nearly overwhelming sense of loss the appearance of their children elicited. There were so many of them, for one thing; the Westboro congregation turned out to be a young one, and even some of the lank-haired women holding signs and spitting epithets turned out be, on closer inspection, teenagers. And they were all so poor. I’m not speaking simply of their clothes, and their teeth, and their grammar, or any of the other markers of class in America. I’m speaking of their poverty of spirit. Whether they were sixteen or six, they looked to be already exhausted, already depleted, with greasy hair, dirty faces, and circles under their eyes that had already hardened into purplish dents. They looked as if they were far from home, and didn’t know where they were going next. They looked, in truth, not just poorly taken care of, but abused, if not physically then by a belief inimical to childhood—the belief that to be alive is to hate and be hated.

Dave Weigel notes the relationship Phelps had with the media:

We can agree on this: He was hilariously stupid, and stupid people provide good copy. For a generation, ever since his flamboyant “God Hates Fags” signs went viral (before there was even a modern Internet for things to go viral on), journalists would explore Phelps’ sad little world and bait him.

David Von Drehle wishes Westboro hadn’t gotten so much coverage:

As a reporter and editor in some big newsrooms over the past 30 years, I watched as one journalist after another took Phelps’s bait, then tried to spit out the hook once the dishonesty and shabbiness of the man’s enterprise grew clear. You could fill a gymnasium with the scribes who swore off coverage of Westboro over the years. The only problem was, new and naïve reporters were being minted all the time, ready to believe that Phelps represented some larger darkness beyond the pit of his own person.

Donald McCarthy joins the conversation:

When even Rush Limbaugh rejects the group, you know it’s a rather pathetic target to take on. At this point, saying you hate the Westboro Baptist Church is about as easy as saying you hate the Ku Klux Klan; not exactly a profound statement worthy of approval. A blasting of the WBC is the equivalent of a late night talk show host joking about Kim Kardashian.

The WBC is a target that makes everyone feel good and allows them to ignore mainstream religions’ homophobic tendencies that are more subtle than the signs the WBC members hold. It’s great that the church has provided such a horrible face for homophobia that people now balk from homophobia much more than they used to, but at some point the group’s exposure helps them infinitely more than it helps society.

Scott Shackford hopes the media will finally stop paying attention to the Phelps family:

[T]he death of Fred Phelps probably won’t result in any changes from the family, but it’s a good excuse for the rest of us to move on. I’m sure that right now some dreadful editorial cartoonist is sketching Phelps being met at the pearly gates by all the soldiers his family picketed. It’s true that the solution for bad speech is more speech. But the solution to crazy obsession is not becoming obsessed right back at them. Stop picking at this scab.

(Photo: Fred Phelps, former leader of the Westboro Baptist Church in Topeka, KS. By Michael S. Williamson/The Washington Post via Getty Images)

The first Viking exhibition in three decades at the British Museum in London seeks to set the record straight on these seafaring warriors:

Nico Hines explores how the Vikings got such a bad reputation:

It seems this was a rare era in which history was not written by the victors; mostly because the victors couldn’t write. It was left to monks and Christian churchmen to craft the only contemporary accounts of many of the Vikings’ raids, and Vikings did attack churches, which held no sacred mystique for them. They were simply seen as easy, wealthy targets, confounding local conventions of the time.

“These accounts are dressed up in the language of religious polemic,” [British Museum curator Gareth] Williams said. “Many [of the stories] were borrowed from earlier accounts—from classical antiquity. The violent reputation and particularly the reputation for atrocities was created then, but the Vikings were probably no worse than anyone else.”

Mark Hudson is captivated by the Viking ship in the final room of the exhibit:

Only about a quarter of the original dark timbers are present, fitted into a modern metal frame, but the sheer scale of the craft and the dynamic sweep of its curving bows are immensely impressive. For the Vikings, we are reminded, the sea was a route rather than a barrier. Theirs was a culture that resided in waterborne movement rather than in the monuments that come with settled culture. If that’s a difficult idea to get across in an exhibition, which will inevitably be all about objects, the thought of this magnificent ship slicing through the freezing northern Atlantic waves – seen in a looping film at the end of the room – gives a shiver-inducing sense of what Viking travel must have been like.

But Jonathan Jones found the exhibit dry:

Why not weave their tales and the histories written by their enemies into the mix of archaeological stuff to give it warmth and context? The refusal to do so cannot be an oversight. It looks like an archaeological dogma: only material objects painstakingly excavated are to be relied upon as evidence. The rest is romantic twaddle, apparently.

For instance, where are the gods? The picture stone showing a ship arriving at Valhalla is one of just a handful of images of mythology in this exhibition. There’s more about bowls and bracelets than about Thor.

Jones might like the following promotional video more than the substantive one seen above: