Rob Ford: he’s human; he deserves better

Rob Ford’s doctors ‘very concerned’ about cancer reappearance, spokesman says – Toronto – CBC News

“The current goal is to get him healthy enough to receive another round of chemotherapy.”​

Whose “goal” is this? It must be the doctors’ goal – not Ford’s goal and not his family’s.

A lot of social activists object to medical research that inflicts pain/suffering on animals.  Where are they when Rob Ford needs them?

I encourage everyone interested in the relative value of “heroic” medical procedures on patients with terminal disease to read Being Mortal by Atul Gawande, M.D. “…when it comes to the inescapable realities of aging and death, what medicine can do often runs counter to what it should.”

http://www.cbc.ca/news/canada/toronto/rob-ford-hospital-palliative-1.3500989

 

Why I Hope to Die at 75 – The Atlantic

Despite his protestations to the contrary, this guy (whose name I’ve already forgotten) is “crazy, posturing—or worse”, but he makes a lot of good points about how and why geezers should moderate their health care expectations and practices.

Let me be clear about my wish. I’m neither asking for more time than is likely nor foreshortening my life. Today I am, as far as my physician and I know, very healthy, with no chronic illness. I just climbed Kilimanjaro with two of my nephews. So I am not talking about bargaining with God to live to 75 because I have a terminal illness. Nor am I talking about waking up one morning 18 years from now and ending my life through euthanasia or suicide. Since the 1990s, I have actively opposed legalizing euthanasia and physician-assisted suicide. People who want to die in one of these ways tend to suffer not from unremitting pain but from depression, hopelessness, and fear of losing their dignity and control. The people they leave behind inevitably feel they have somehow failed. The answer to these symptoms is not ending a life but getting help. I have long argued that we should focus on giving all terminally ill people a good, compassionate death—not euthanasia or assisted suicide for a tiny minority.

I am talking about how long I want to live and the kind and amount of health care I will consent to after 75. Americans seem to be obsessed with exercising, doing mental puzzles, consuming various juice and protein concoctions, sticking to strict diets, and popping vitamins and supplements, all in a valiant effort to cheat death and prolong life as long as possible. This has become so pervasive that it now defines a cultural type: what I call the American immortal.

I reject this aspiration. I think this manic desperation to endlessly extend life is misguided and potentially destructive. For many reasons, 75 is a pretty good age to aim to stop.

His arguments, detailed in his article, would be much more persuasive if one didn’t have to wade through the self-serving bullshit and aggrandizement.

via Why I Hope to Die at 75 – The Atlantic.

Bicycles Helmets? A Waste of Money?

Here’s a silly study. It purports to measure the effectiveness of bicycle helmets by looking at the  (minimal) changes in fatality rates since cyclists began using them in droves in the 1990s.  The Big Missing in the data is the reduction in the number of serious head injuries resulting from increased helmet usage.  Deaths are tragic to loved ones.  Head injuries are ruinously costly to families and societies.

This is the first concise summary I found on the effectiveness of helmets in reducing head injuries. The meta-analysis concluded that  “helmets provide a 63 to 88% reduction in the risk of head, brain and severe brain injury for all ages of bicyclists.”

The data in the silly study are apparently culled from a 2010Transport Canada study. The article is festooned with Canadian Maple Leafs, suggesting Government of Canada sanction, but it was prepared by a cyclist-rights guy in Ottawa, Ontario.  His organization‘s stated objective has been to oppose “various politicians, bureaucrats, safety lobbyists, and misguided members of certain cycling organizations who would have cyclists ghettoized into bike lanes and onto bike paths, and slap foam hats on everyone’s head” The organization is defunct but the website lives on.

Antibiotic Resistance: blah, blah, blah, blah

Antibiotic Resistance: A Mismanaged Public Good

Yes, we all know that bacteria and other microbial beasties are developing resistance to antibiotics faster than scientists can develop new antibiotics.  Same old, same old, right?   This interesting article doesn’t offer specific solutions but it opens a door, I think.  It suggests that the Tragedy of the Commons phenomenon is a good analogy to the over-prescription and over-use of antibiotics.  The costs of over-use are not borne by the over-users; they’re borne by the rest of society. The free market isn’t working.  Regulatory intervention may be required to ensure that all the costs are borne by the producers (and thus reflected in their prices.)

Having nicely encapsulated the problem, author Timothy Taylor, the Conversable Economist, offers a few unrealistic solutions to the problem of growing antibiotic resistance:

  • invent our way out of the problem with new groups of antibiotics;
  • avoid over prescribing antibiotics;
  • more hand-washing and sterilization, which would reduce the need to prescribe antibiotics

Seriously – “more hand-washing”?

Instead, why not slap a Federal Excise Tax on the sale of antibiotics used for food animal production?  Tasty as they are, food animals are responsible for about half of all the antibiotics sold in the US. The cost of the antibiotics to the farmer is very small; the cost of growing antibiotic resistance to the population at large is very high.  Tragedy of the Commons.  We should tax the farmers and use the proceeds to bring an NHL team to Seattle – or something else worthwhile like funding basic research into new ways to fight bacterial infections.

What’s that you say, “The farmers are already living at subsistence level* and any further taxes will drive them off the farm and jeopardize our nation’s food independence.”?  Corporations, not farmers, raise food animals.  If the corporations can’t absorb the additional tax (reducing their profit) they will raise their prices.  Yes, this will result in a lot of Meatless Mondays, Tofu Tuesdays, and Wegetable Wednesdays.  It’s a small price to pay.

*P.S. Don’t get me started on the subsidies that our governments already pay to the farmers who raise these food animals.  That’s the subject for another column.

via CONVERSABLE ECONOMIST: Antibiotic Resistance: A Mismanaged Public Good.

Delphi told panel GM approved ignition switches below specifications | Reuters

I think I would like to meet the GM engineering team responsible for developing the specs for the torque on the ignition switches.  I imagine they lead pretty sheltered, narrow lives.  But perhaps the gravy days are over.
“According to one entry of the chronology in the memo, officials of Delphi, which supplied the ignition switches to the recalled GM cars, told committee investigators that GM had approved the part, even though sample testing of the ignition switch torque was below the original specifications set by the automaker.
http://www.reuters.com/article/2014/03/30/us-gm-recall-congress-idUSBREA2T0HO20140330

via Delphi told panel GM approved ignition switches below specifications | Reuters.

Miami Beach: pumping storm water into the aquifer

This is part of an interview on PBS Nightly News.  The interview was generally positive, good for Miami Beach for getting rid of the storm water.  (The storm water sewers don’t drain into the ocean as reliably as it used to, now that the ocean often rises above the level of the sewers.)  I guess the ground water under southern Florida isn’t good for too much, but surely there is some potable water down there.  Otherwise where do the locals get their drinking water?  (Wal-Mart?)

Regulations in most other locations require strict isolation of surface water from ground water.  The damages ensuing from a contaminated aquifer are incalculable.

Maybe they pump the storm water underground in an attempt at remediation: reducing the number of sink holes on the surface that are caused by pumping fresh water out of the ground.  Still – it’s nuts to pump storm water underground.

KWAME HOLMAN: The Miami Beach Public Works Department is working on improvements now.

ERIC CARPENTER, Miami Beach Public Works Department: We have done our storm water management master plan that was adopted in 2012, and that had identified approximately $200 million worth of improvements that we needed to do over the next 20 years in order to keep pace with sea level rise and addressing flooding concerns within the city of Miami Beach.

KWAME HOLMAN: Some of that infrastructure includes pumps.

RICK SALTNICK, Senior Capital Projects Coordinator: Everything collects on the inlets on the streets and then runs through those white pipes down there. They’re PVC pipes. They then all drain via gravity to the storm water pump station, and then pumped out of the storm water pump station and injected into the ground 80 to 100 feet down.

We’re sizing these pumps to provide the proper level of service 20 years from now and at the sea level 20 years from now.

via South Florida considers investment against rising seas.

Toronto neighbourhoods ranked by new ‘equity score’ – The Globe and Mail

This is nuts….a new collective metric, “equity”, which is an index of a bunch of other indexes which are individually and collectively debatable among economists and sociologists till the cows come home.

  • economic opportunity,
  • social development,
  • health,
  • participation in decision-making, and
  • physical surroundings

via Toronto neighbourhoods ranked by new ‘equity score’ – The Globe and Mail.