Monthly Archives: February 2013

The Horse Behind the Cart

by Marc Grober

Some weeks ago, Kathleen McCoy spent not a few column inches of the local rag  in her puff piece lauding UAA’s Terry Kelly, “Ethicist handles heavy issues with a light touch.” Unfortunately, one can only conclude that this is further evidence that UAA is not a real educational destination.
horse-cart

UAA’s Terry Kelly must be more a stand-up comic than an ethicist. According to McCoy, he argued, in the most bizarre example of political correctness to date, that if you act in such a way as to make some one else be suspicious of you, you have acted unethically. Yes, you heard me. By way of example, Kelly offered a homily where a husband and wife pledge to be sexually faithful, and then hubbie goes off to spend Friday nights reading at the whorehouse. Kelly claimed that hubbie is acting unethically because his pathetically insecure wife is banging her head against a wall. Really?

Kelly then went on to confuse matters with a retelling of the Clinton/Lewinsky gaffe, misrepresenting the facts and of course drawing the wrong conclusion. He finally tackled his real target (after an unfortunate attempt to hijack the theory of cognitive dissonance), which appeared to be the impact of government officials receiving gifts. He apparently closed with something along the lines of “trustworthy behavior is persuasive behavior, and untrustworthy behavior is unethical.”

Yes. Instead of arguing that trust is based on ethical behavior, he argues that ethical behavior is based on trust. Very inventive. Or delusional. The word trust comes from the Norse “traust” and is defined by the Cambridge dictionary as “to have belief or confidence in the honesty, goodness, skill or safety of a person, organization or thing.” Trustworthy of course is to be worthy of trust. Ethics, per the Oxford Dictionary, are, “moral principles that govern a person’s behaviour or the conducting of an activity”, and the entry goes on to explain:

Schools of ethics in Western philosophy can be divided, very roughly, into three sorts. The first, drawing on the work of Aristotle, holds that the virtues (such as justice, charity, and generosity) are dispositions to act in ways that benefit both the person possessing them and that person’s society. The second, defended particularly by Kant, makes the concept of duty central to morality: humans are bound, from a knowledge of their duty as rational beings, to obey the categorical imperative to respect other rational beings. Thirdly, utilitarianism asserts that the guiding principle of conduct should be the greatest happiness or benefit of the greatest number

So we can take ethical to mean, depending on the system to which you subscribe, compliance with some code of conduct. In sum, we may have confidence that others may conduct themselves ethically, but if we lack confidence how can that possibly change whether the erstwhile target of out attentions is ethical or not?

What Terry Kelly has proposed is nothing less than a feedback loop, a neurotic echo chamber where what is real is not what you do, but what someone perceives you to do. While in a very primitive form this may hearken back to the social psychology of the ’70s and the concept of the social construction of reality, it beggars the concept of ethics, for it renders ethics dependent on the feedback loop and enables insecurity. You can only be as ethical as you convince your observer you are. He has turned philosophy into advertising, for under his rules, one becomes ethical not by adhering to a code, but by convincing others that one does, and after all, that is what our politicians try to do today, and is exactly opposite of the point we think Kelly was trying to argue. Kelly has shifted the subjective lens, and lost sight of the situation entirely.

Only His Hairdresser Knows for Sure…..

by Marc Grober

A year or so ago UAA Nursing Students decided to put the question of whether the recommended daily allowance (RDA) of Vitamin D would produce adequate blood levels to the test and found that the RDA came nowhere close to ensuring adequate Vitamin D. Alaskan doctors are now suggesting 4000 IU daily (combined with Magnesium and Calcium) while many foolish Alaskans complain or suffer from the conditions listed below and do nothing about it.

Now a Republican Alaska State Senator has announced he is interested in doing something about this. Senator Seaton wants to test newborns for Vitamin D, while the Republican Administration dismisses concerns over the impact of inadequate Vitamin D. HB90 would create a “temporary” program for testing newborns at delivery. The text of the Bill and the Sponsor statement (available here) is well worth the read.

A big problem, however, is that Alaska hospitals have made a habit out of turning parents of newborns into criminals as they surreptitiously turn maternal blood test results over to OCS and State police over even the legal presence of anything “suspicious” in the blood, and let’s face it, Seaton’s colleagues seem much more interested in regulating wombs and criminalizing female behavior than in addressing any health care issue. Moreover, it would clearly be more important from all perspectives to have pre-natal data from pregnant mothers than on new born children, but Alaska is certainly not interested in ensuring that all women have adequate prenatal care.

The wing nut right fail to see this as one might argue the GOP caucus does (as a way to seize further control of women) and look at it instead through delusional Lockean glasses, arguing that Seaton is intruding into the individual’s privacy and that the legislature has no business addressing public health issues (except when it is someone else.) Of course, this is in no small part because though they scream and yell that we should be complying with the Constitution, they have never read that document (save perhaps to support amending same to fund religious schools.) The Constitution mandates 1 that the Legislature must address the general health and welfare, which is clearly challenged by the gross inadequacy of Vitamin D.

What a mess! We seem to have an unholy alliance of liberals and conservatives to wrest control of pre and post natal care from parents while failing to really acknowledge the underlying health issues facing Alaskans and the need to boldly address same (Governor Sean Parnell, is even an embarrassment to Governor Brewer, who finally admitted that her state needs to get onboard with the ACA.) The GOP legislative caucuses are VERY busy rushing ALEC based repressive legislation in to law, and really can’t be bother with health policy.

So we all have a dilemma, here in the far north. Is Senator Seaton et al really concerned about the health of Alaskans, or are they merely looking for a way to ensure that all mothers get drug tested? The shortsighted nature of the policy and the questionable ethics of the caucus suggests that one look beyond the purported purpose of the Bill, but is Seaton really that much of a prat? Well…….

Impacts of a Vitamin D deficiency 2
1.) The flu – In a study published in the Cambridge Journals, it was discovered that vitamin D deficiency predisposes children to respiratory diseases. An intervention study conducted showed that vitamin D reduces the incidence of respiratory infections in children.

2.) Muscle weakness – According to Michael F. Holick, a leading vitamin D expert, muscle weakness is usually caused by vitamin D deficiency because for skeletal muscles to function properly, their vitamin D receptors must be sustained by vitamin D.

3.) Psoriasis – In a study published by the UK PubMed central, it was discovered that synthetic vitamin D analogues were found useful in the treatment of psoriasis.

4.) Chronic kidney disease – According to Holick, patients with advanced chronic kidney diseases (especially those requiring dialysis) are unable to make the active form of vitamin D. These individuals need to take 1,25-dihydroxyvitamin D3 or one of its calcemic analogues to support calcium metabolism, decrease the risk of renal bone disease and regulate parathyroid hormone levels.

5.) Diabetes – A study conducted in Finland was featured in Lancet.com in which 10,366 children were given 2000 international units (IU)/day of vitamin D3 per day during their first day of life. The children were monitored for 31 years and in all of them, the risk of type 1 diabetes was reduced by 80 percent.

6.) Asthma – Vitamin D may reduce the severity of asthma attacks. Research conducted in Japan revealed that asthma attacks in school children were significantly lowered in those subjects taking a daily vitamin D supplement of 1200 IU a day.

7.) Periodontal disease – Those suffering from this chronic gum disease that causes swelling and bleeding gums should consider raising their vitamin D levels to produce defensins and cathelicidin, compounds that contain microbial properties and lower the number of bacteria in the mouth.

8.) Cardiovascular disease – Congestive heart failure is associated with vitamin D deficiency. Research conducted at Harvard University among nurses found that women with low vitamin D levels (17 ng/m [42 nmol/L]) had a 67 percent increased risk of developing hypertension.

9.) Schizophrenia and Depression – These disorders have been linked to vitamin D deficiency. In a study, it was discovered that maintaining sufficient vitamin D among pregnant women and during childhood was necessary to satisfy the vitamin D receptor in the brain integral for brain development and mental function maintenance in later life.

10.) Cancer – Researchers at Georgetown University Medical Center in Washington DC discovered a connection between high vitamin D intake and reduced risk of breast cancer. These findings, presented at the American Association for Cancer Research, revealed that increased doses of the sunshine vitamin were linked to a 75 percent reduction in overall cancer growth and 50 percent reduction in tumor cases among those already having the disease. Of interest was the capacity of vitamin supplementation to help control the development and growth of breast cancer specially estrogen-sensitive breast cancer.

1 Alaska Constitution Article 7  http://ltgov.alaska.gov/treadwell/services/alaska-constitution/article-viiA096A0health-education-and-welfare.html

2  Geib, Aurora. “The 10 symptoms of vitamin D deficiency you need to recognize” Natural News, 2/10/2012 Web http://www.naturalnews.com/035089_vitamin_D_deficiency_signs_symptoms.html

Mediating Self Medication

by Marc Grober

Screen Shot 2013-02-20 at 3.01.56 PMDr. Gabor Maté argued to Alaska that, “The first question in addiction is not why the addiction, but why the pain? And if you understand a human being’s pain, you cannot look at their genes.” You can listen to his presentation at http://www.alaskapublic.org/2013/02/15/addiction-from-heroin-to-workaholism/ .  While the proposed historical basis for his arguments are dubious, and the jargon makes one shudder to think of Fritz Perl voodoo and the modern profit center of “mental health”,  there is a good deal to be said for a functional approach to addiction, and under the patina of the sloppy academics and loose jargon, that is, after all, what the good doctor is talking about.

Maté, like some medical analog of D’Souza’s “nemesis”, argues that western imperialism is responsible for “addiction”, in that while tribal people may use psychoactive substances, they do so reverently and with cultural approval, and therefore not addictively. Apparently the pervasive and ubiquitous use of betel nut, coca leaf and other similar substances   (Sullivan and Hagen), are overlooked by Maté. Maté only has eyes for noble savages, while Anthropology retired that trope years ago (Ellingson, Grinde et al., Hames.)

But the presentation, ”The Hungry Ghost: A Biospsychosocial Perspective on Addiction, from Heroin to Workaholism” based on the book “In The Realm of Hungry Ghosts: Close Encounters with Addiction“, can be forgiven the blood libel. The important bit is that Maté effectively makes the case that addicts are not necessarily the insane and mentally ill, nor deviant fiends bent on breaking the law; they are as likely to be persons doing their best to essentially self-medicate themselves to states in which they can survive.

And THAT serves as an excellent indictment of both the criminal justice approach to addiction AND the mental health approach to addiction. The former punishes the addict for attempting to comply with other’s  rules, and the latter denies the rationality of the user.

I don’t want to sink in to some ridiculous libertarian rant about natural rights; that is not what this is about. What we have done, though, is created a religion in which the MDs are high priests and BigPharma are the keepers of the sacraments. If I can manage what ails me through moderate use of caffeine and marijuana, why should I not be permitted to do so? Is the threat of societal implosion from a 7% solution so extraordinary that we must so vehemently denounce so much of our world?

Perhaps what we need more of are not the empty chairs of Gestalt Therapy (yes, Clint was engaging in classic Gestalt therapy during the GOP convention) nor private prison beds (rendering Puritanism a profit center), but effective mediators.  Once upon a time I think we called such people social workers; persons who went out in to the community and assisted others in coping with a society whose demands were in some respect more than one might be able to manage. We don;t need to talk about defective genes; we need to talk about a dysfunctional society, and what we can do to recognize and perhaps moderate the responses of some to that dismal fact of life. No, there are no silver bullets,  but having some understanding of the underlying circumstances, and abandoning the Puritan intolerance that drives even those who deny same, will be a start.

 

 Work Cited

Ellingson, Ter. The Myth of the Noble Savage. University of California Press, 2000. Print.
Grinde, Donald A., Bruce Elliott Johansen, and University of California, Los Angeles American Indian Studies Center. Exemplar of Liberty: Native America and the Evolution of Democracy. American Indian Studies Center, University of California, Los Angeles, 1991. (http://www.ratical.org/many_worlds/6Nations/EoL/index.html)
Raymond, Hames. “The Ecologically Noble Savage Debate.” Annual Review of Anthropology 36.1 (2007): 177–190. Web http://www.annualreviews.org/doi/abs/10.1146/annurev.anthro.35.081705.123321. 20 Feb. 2013.
M.D, Gabor Mate. In the Realm of Hungry Ghosts: Close Encounters with Addiction. North Atlantic Books, 2011. Print.
Sullivan, R. J., and E. H. Hagen. “Psychotropic Substance-seeking: Evolutionary Pathology or Adaptation?” Addiction 97.4 (2002): 389–400. Web http://onlinelibrary.wiley.com/doi/10.1046/j.1360-0443.2002.00024.x/full. 20 Feb. 2013.