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Monday, February 27, 2017

Just the Facts...

"One hopes not only for the courage of one’s convictions, but also for the courage of one’s doubts in a world of dangerously passionate certainties." - the late Eric Sevareid, Not So Wild A Dream


My out-of-print original hardcover copy of Eric Sevareid's riveting book is one of my prized possessions.

Among my favorite undergraduate professors during my time at Tennessee (UTK, 1980-85) was Dr. Sheldon Reaven (now teaching at Stony Brook). I first had him for "Inductive Logic," which he subtitled on the syllabus "Lying With Statistics." I subsequently took his class in "Philosophy of Science," which was an utter delight. It has infused my thinking to this day.

I still recall his admonishment to the class: "If you take one thing away from your four years here (five in my case, as it would turn out), it should be the difficulty in determining what actually counts as a 'fact'."

So, yeah, and here we are today several decades later, during a "WTF?" time of Trump apologist Kellyanne Conway's "alternative facts," and the broader Trump administration dismissal of any and all incumbent-economics-inconvenient science.

I first ruminated relatively narrowly on this notion (in the context of medical science) nearly 20 years ago, during my late daughter's cancer struggle.
'Arrogant, narrow-minded, greedy, and indifferent?'
Is science the enemy? To the extremist "alternative healing" advocate, the answer is a resounding 'yes'! A disturbing refrain common to much of the radical "alternative" camp is that medical science is "just another belief system," one beholden to the economic and political powers of establishment institutions that dole out the research grants and control careers, one that actively suppresses simpler healing truths in the pursuit of profit, one committed to the belittlement and ostracism of any discerning practitioner willing to venture "outside the box" of orthodox medical and scientific paradigms.

One e-mail correspondent, a participant in the internet newsgroup alt.support.cancer, vented splenetic at length recently regarding U.S. authorities' alleged hounding, arrest, and imprisonment of alternative healers. He railed that law enforcement, at the behest of the AMA/FDA Conspiracy (a.k.a. the "corrupt AMA/FDA/NCI/ACS cartel"), had made the practice of alternative medicine illegal in the U.S. Moreover, he considered the fact that medical science can only claim "cures" for approximately 10% of the roughly 10,000 classified human diseases an a priori indictment of the mainstream profession.

I know: this is akin to the U.N. Black Helicopters/One-World-Government Conspiracy stuff of the not-too-tightly-wrapped. Still, I couldn't resist-- pointing out in (no doubt futile) reply that no one came with guns drawn and cuffs at the ready the night at Brotman Rehab when "Healing Angelite Crystals" practitioners-- devotees of India's Sai Baba-- came from Topanga Canyon to hover for hours in ceremony over Sissy (to the curious and wary befuddlement of the night shift nurses); neither did Security nor the medical staff at Brotman confiscate the goopy-looking herbal tonic we brought in, an elixir prescribed for Sissy by a Chinese herbal pharmacist doing business quite openly in Chinatown near downtown L.A.; nor would SWAT teams pounce on the backyard in the Valley where we took part in evening-long Lakota Souix "healing sweat lodge" ceremonies conducted by the venerable Wallace Black Elk; and finally, Wyndie, one of Sissy's highly skilled and effective physical therapists at Brotman did not have her certification revoked for counseling my daughter on the Hindu principles of the Chakras and efficacy of aromatherapy.

Moreover, I had to respond, the fact that we can only cure 10% of known diseases implies nothing regarding the quality of mainstream medical research and practice, unless the alternatives industry can provide hard, "case-mix adjusted," scientifically valid data showing their methods to effect consistently and significantly better outcomes-- which they cannot (a dearth of peer-reviewed studies being a central characteristic of "alternative" practice). Additionally, I asked, can anyone even cite historical curative percentages from 30, 50, or perhaps 100 years ago? Indeed, even such statistics would prove problematic-- "shooting at a moving target," as it were-- in that more subtle and clinically unresponsive maladies continue to be discovered and classified while the easier to treat are dealt with more readily. And, classificatory observation is easy compared to the work and resources required to effect cures; we should expect that identification will outpace remedy. Finally, 50 years ago death certificates listing demise from "natural causes" would today likely have identifiable diseases recorded as the cause of death.

Purveyors of medical quackery should fear the hot breath and hard heel of competent authority, but I see no evidence of suppression of alternative therapy methods that are not certifiably fraudulent. All manner of "unproven" substances are sold quite openly at retail, both in the health food stores and in the national chain outlets; all that need accompany the product is the legal boilerplate disclaimer acknowledging an absence of FDA blessing, along with the inoculating phrase 'dietary supplement'...
 ...Every discipline has its share of the "arrogant and narrow-minded," but I have mostly found mainstream health care professionals to be a dedicated, unpretentious, and self-deprecating lot quite aware of the limits of their knowledge and the risks of presumption. Once, during a series of health care quality improvement seminars I attended at Intermountain Health Care in Salt Lake City during my Peer Review tenure, a speaker-- himself a noted pediatric surgeon-- wryly observed that "the best place to hide a hundred dollar bill from a doctor is inside a book." The Director of the seminar series, Dr. Brent James of IHC (and a Fellow of the Harvard School of Public Health), noted in our opening session that physicians would probably admit-- off the record, of course-- that perhaps only 10% of their clinical decisions made during daily practice could be traced to the peer-reviewed scientific literature. Dr. James also made the droll observation that, were you to walk into the typical medical adminstrator's office, "you'd be much more likely to see copies of the Wall Street Journal rather than the New England Journal strewn about."

What can one take away from such remarks? First, the many physicians I have come to know in the past few years are in the main acutely sensitive to the problems of clinical conceit and "paradigm blinders." Indeed, the Utah pediatrician's"$100 bill" wisecrack was offered to an audience of doctors and their allied health personnel during quality improvement training. Second, the body of peer-reviewed medical literature does not constitute a clinical cookbook; even "proven" therapies-- particularly those employed against cancers-- are generally incremental in effect and sometimes maddeningly transitory in nature. The sheer numbers of often fleeting causal variables to be accounted for in bioscience make the applied Newtonian physics that safely lifts and lands the 747 and the space shuttle seem child's play by comparison. Astute clinical intuition is a necessary component of a medical art that must, after all, act and act quickly-- so often in the face of indeterminate, inapplicable, or contradictory research findings...
Nowadays we face a full-frontal assault of Denialism spanning the breadth of science.

As I noted earlier on the blog, I joined AAAS, and am now getting their flagship magazine "Science." From the February issue:

A Matter of Fact
by David Malakoff


This is a worrying time for those who believe government policies should be based on the best evidence. Pundits claim we've entered a post-factual era. Viral fakes news stories spread alternative facts. On some issues, such as climate change and childhood vaccinations, many scientists worry their hard-won research findings have lost sway with politicians and the public, and feel their veracity is under attack. Some are taking to the Internet and even to the streets to speak up for evidence. But just how should evidence shape policy? And why does it sometimes lose out?

Is this special section shows, evidence still plays a key role in the machinery of government, especially in the robust bureaucracies of the United States and Europe, where legal mandates often require the input of technical specialists. Many politicians and policy wonks also want to better understand the problems they are trying to solve, whether costly policy remedies will be effective, and whether taxpayers will get their money's worth. So they demand data as they make decisions on a wide range of issues, including how to regulate toxic chemicals, evaluate education programs, treat disease, and shape policies that can affect vast swaths of the economy and millions of people.

 That doesn't mean the path of evidence to policy is straight, or that the evidence always determines the outcome. There's no question that carbon dioxide is building up in the atmosphere and before long will  increase global temperatures by 2°C if emissions aren't curbed. But those numbers can't tell a policymaker whether the best way to limit warming is to impose a carbon tax, create an emissions trading system, an active ban on fossil fuels, or simply do nothing and let the next generation figure it out.

 That last idea might not be responsible, but it's a reminder that evidence is just one of many ingredients — along with economic concerns, religious views, and ideological perspectives on the role of government — that go into the policy mix. Even before "alternative facts" became a meme, belief and ideology sometimes trumped evidence, as when parents rejected vaccines for their children and politicians snubbed potentially life-saving interventions for drug abusers.

 There are other complexities. Even in arenas where evidence is essential — such as deciding whether a drug is safe for how to regulate a pollutant — there can be honest disagreements about what kinds of evidence should be allowed into the process. All studies are not equal.

 Then there is the problem of what policymakers should do when studies offer no clear-cut answer to the question at hand — or conflicting evidence. It's safe to say that, in many areas, more study is almost always needed. But what to do in a world where resources for more science are almost always limited, and decisions need to be made?

 Veterans of the policy wars say such hurdles shouldn't prevent scientists from enlisting. But don't go unarmed. Learn the lingo, and identify the key players. Realize that the path of evidence is winding, and the destination is often distant. It's not unusual for it to take decades for the weight of evidence to leave its mark on policy. But when it does, the results can often be extraordinary, saving millions of lives, and reminding people of the power of fact.
"JUST THE FACTS?"

From Time Magazine recently:
Bret Stephens writes the foreign-affairs column of the Wall Street Journal, for which he won the 2013 Pulitzer Prize for commentary.

Bret Stephens delivered the Daniel Pearl Memorial Lecture this week at the University of California, Los Angeles. Read the full text of his remarks below:


I’m profoundly honored to have this opportunity to celebrate the legacy of Danny Pearl, my colleague at The Wall Street Journal.


My topic this evening is intellectual integrity in the age of Donald Trump. I suspect this is a theme that would have resonated with Danny.


When you work at The Wall Street Journal, the coins of the realm are truth and trust — the latter flowing exclusively from the former. When you read a story in the Journal, you do so with the assurance that immense reportorial and editorial effort has been expended to ensure that what you read is factual.


Not probably factual. Not partially factual. Not alternatively factual. I mean fundamentally, comprehensively and exclusively factual. And therefore trustworthy. 


That is how we operate...
Yeah. "Just the facts, ma'am." It is really that simple? 

"THE POWER OF FACT?"

Elizabeth Kolbert, in The New Yorker:

WHY FACTS DON’T CHANGE OUR MINDS
New discoveries about the human mind show the limitations of reason.
...Even after the evidence “for their beliefs has been totally refuted, people fail to make appropriate revisions in those beliefs,” the researchers noted. In this case, the failure was “particularly impressive,” since two data points would never have been enough information to generalize from.

The Stanford studies became famous. Coming from a group of academics in the nineteen-seventies, the contention that people can’t think straight was shocking. It isn’t any longer. Thousands of subsequent experiments have confirmed (and elaborated on) this finding. As everyone who’s followed the research—or even occasionally picked up a copy of Psychology Today—knows, any graduate student with a clipboard can demonstrate that reasonable-seeming people are often totally irrational. Rarely has this insight seemed more relevant than it does right now. Still, an essential puzzle remains: How did we come to be this way?

In a new book, “The Enigma of Reason” (Harvard), the cognitive scientists Hugo Mercier and Dan Sperber take a stab at answering this question. Mercier, who works at a French research institute in Lyon, and Sperber, now based at the Central European University, in Budapest, point out that reason is an evolved trait, like bipedalism or three-color vision. It emerged on the savannas of Africa, and has to be understood in that context.

Stripped of a lot of what might be called cognitive-science-ese, Mercier and Sperber’s argument runs, more or less, as follows: Humans’ biggest advantage over other species is our ability to coƶperate. Coƶperation is difficult to establish and almost as difficult to sustain. For any individual, freeloading is always the best course of action. Reason developed not to enable us to solve abstract, logical problems or even to help us draw conclusions from unfamiliar data; rather, it developed to resolve the problems posed by living in collaborative groups.

“Reason is an adaptation to the hypersocial niche humans have evolved for themselves,” Mercier and Sperber write. Habits of mind that seem weird or goofy or just plain dumb from an “intellectualist” point of view prove shrewd when seen from a social “interactionist” perspective...
Read the entire article carefully. I've been onto Sperber and Mercier for a long time. See my right-hand links column permanent linked paper "Why do humans reason?" (pdf). Basically to win the argument, not to get at objective truths (think, well, trial lawyers). In sum, "the pen is mightier than the sword" adaptive utility.

SCIENCE-BASED MEDICINE

If clinical information is "the lifeblood of healthcare" (with Health IT being its cardiovascular system), then the scientific method is its neurology. One of my priority daily web stops is that of ScienceBasedMedicine.org. They've just published a book.


Only $4.99 Kindle price, and well worth it. A sort of topical "greatest hits" compendiums of postings from the voluminous blog. I ran across a review of it over at The Neurologica Blog.
Introduction 
Steven Novella 

The world of health care is becoming an increasingly complex and challenging place. The internet is changing the way we generate and access information, and health information is one of the most popular uses of the internet. It represents an unprecedented democratization of information and opinion. 

While there are many advantages and benefits to such information access, there are also many challenges to health professionals, regulators, academics, and consumers. There is a proliferation of health related products and services, with many provocative health claims. Regulations are generally not keeping up, and often have been watered down, in the face of this onslaught of claims and products. 

The consumer is left with an overwhelming array of health claims, many of which challenge and even directly oppose the traditional experts and institutions. The mission of Science-Based Medicine (SBM) is to be a source of reliable information and analysis to help navigate the wild west of health information on the internet and elsewhere. The authors who contribute to this series of e-books are all physicians and other health care professionals who have a great deal of experience educating the public about complex medical issues. We especially take on controversial issues and try to expose pseudoscience and fraud wherever possible. 

The Philosophy of Science-Based Medicine 
The philosophy of SBM, at its core, is simple: Safe and effective health care is critical to everyone’s quality of life; so much so that it is generally considered a basic human right. Therefore, health care products and services that work and are safe are better than those that do not work or are unsafe. 

The best method for determining which interventions and health products are safe and effective is, without question, good science. Therefore it is in everyone’s best interest for health care to be systematically evaluated by the best science available. 

Too often the nature of science itself is misunderstood or misrepresented to the public. Science is not an arcane and privileged discipline. By its very nature it is meant to be transparent and public. Science is nothing more than a systematic and careful use of evidence and logic to evaluate factual claims. And good science possesses certain virtues that are not unique to science but generic to all intellectual endeavors: fairly accounting for all available evidence, using valid and internally consistent logic, using unambiguous concepts and language, proper use of statistics, being quantitatively precise and accurate, and above all being honest. 

And yet there are numerous and powerful influences in society that strongly appose the scientific basis of medicine. Driven by some combination of ideology or the desire for profit they wish to eliminate standards of science in health care, or (often under the guise of “health care freedom”) create a double standard in which unscientific methods and products can thrive unchecked. Others simply lack the training or knowledge to achieve minimal standards of quality for scientific medicine. And even the best traditions of scientific medicine can benefit from more critical analysis...

Executive Editor Steven Novella, Managing Editor David Gorski, Series Editor Mark Crislip. (2013-04-05). Science-Based Medicine: Guide to Critical Thinking (Kindle Locations 10-34). James Randi Educational Foundation. Kindle Edition.
The in-depth discussions regarding the logic of Bayesian reasoning alone make it worth it. BTW, speaking of Bayes, a nice relatively non-technical primer is here (only $2.99):


I cited it back in this prior post. I once riffed on Bayes back in 2002 while calling BS on the proposed federal "Total Information Awareness" data surveillance inititative. Color me thoroughly Bayesian.

Jaynes on Bayes:
For many years, there has been controversy over ‘frequentist’ versus ‘Bayesian’ methods of inference, in which the writer has been an outspoken partisan on the Bayesian side. The record of this up to 1981 is given in an earlier book (Jaynes, 1983). In these old works there was a strong tendency, on both sides, to argue on the level of philosophy or ideology. We can now hold ourselves somewhat aloof from this, because, thanks to recent work, there is no longer any need to appeal to such arguments. We are now in possession of proven theorems and masses of worked-out numerical examples. As a result, the superiority of Bayesian methods is now a thoroughly demonstrated fact in a hundred different areas. One can argue with a philosophy; it is not so easy to argue with a computer printout, which says to us: ‘Independently of all your philosophy, here are the facts of actual performance.’ [Preface p. xxii, “Probability Theory. The Logic of Science” E.T. Jaynes]
I also recommend Steven Hatch's "Snowball in a Blizzard: a Physician's Notes on Uncertainty in Medicine" (cited in that post as well).


apropos of all of the foregoing broadly, see my citation of UW's course in "Calling Bullshit" in my prior post.

Also relevant, my review of Dr. James T. Hamilton's book "Democracy's Detectives" in my prior post "I am not a scientist."


"Accountability journalism," a.k.a. "investigative reporting." More important than ever during this Trump era of STEM Denialism.

I don't underestimate the difficulties here. First, the Eric Sevareid quote at the top of this post can be construed as cutting both ways. At what point does rational skepticism bleed over into intransigent "yes, but" denialism? Moreover, in light of the durability of denialism, how best do proponents of the scientific method "get over," "make the case?"

I have some ideas there. Stay tuned.

UPDATE: ADD ANOTHER BOOK TO THE PILE

Just in at The Neurologica Blog:
The Death of Expertise
Steven Novella

Tom Nichols’ book, “The Death of Expertise: The Campaign Against Established Knowledge and Why it Matters,” is currently on the Amazon bestsellers list. The book discusses a topic I have delved into many times here – what are the current general attitudes of the public toward experts and expertise, and how did we get here?

He mentions various aspects to this war against experts:

“The United States is now a country obsessed with the worship of its own ignorance. Many citizens today are proud of not knowing things. Americans have reached a point where ignorance, especially of anything related to public policy, is an actual virtue.”
The culture and our educational system have created a generation that has little experience being told they are objectively wrong. Everyone feels they are entitled to be right. Combine this with the illusion of knowledge provided by Google, and everyone thinks they are their own expert in anything...

Like I don't already have enough to read.

Popular in the Bible Belt of late -- "Prius repellent."


From the Tom Nichols book:
"Principled, informed arguments are a sign of intellectual health and vitality in a democracy."

“The death of expertise” is one of those phrases that grandly announces its own self-importance. It’s a title that risks alienating a lot of people before they even open the book, almost daring the reader to find a mistake in it somewhere just to take the author down a peg. I understand that reaction, because I feel much the same way about such sweeping pronouncements. Our cultural and literary life is full of premature burials of everything: shame, common sense, manliness, femininity, childhood, good taste, literacy, the Oxford comma, and so on. The last thing we all need is one more encomium for something we know isn’t quite dead. 

While expertise isn’t dead, however, it’s in trouble. Something is going terribly wrong. The United States is now a country obsessed with the worship of its own ignorance. It’s not just that people don’t know a lot about science or politics or geography; they don’t, but that’s an old problem. And really, it’s not even a problem, insofar as we live in a society that works because of a division of labor, a system designed to relieve each of us of having to know about everything. Pilots fly airplanes, lawyers file lawsuits, doctors prescribe medication. None of us is a Da Vinci, painting the Mona Lisa in the morning and designing helicopters at night. That’s as it should be. 

No, the bigger problem is that we’re proud of not knowing things. Americans have reached a point where ignorance, especially of anything related to public policy, is an actual virtue. To reject the advice of experts is to assert autonomy, a way for Americans to insulate their increasingly fragile egos from ever being told they’re wrong about anything. It is a new Declaration of Independence: no longer do we hold these truths to be self-evident, we hold all truths to be self-evident, even the ones that aren’t true. All things are knowable and every opinion on any subject is as good as any other. 

This isn’t the same thing as the traditional American distaste for intellectuals and know-it-alls. I’m a professor, and I get it: most people don’t like professors. When I began my teaching career nearly three decades ago, it was at a college not far from my hometown, and so I would drop in now and then to say hello and visit a small tavern owned by my brother. One evening, after I left, a patron turned to my brother and said, “He’s a professor, huh? Well, he seems like a good guy anyway.” If you’re in my profession, you get used to that. 

But that’s not why I wrote this book. Intellectuals who get outraged over zingers about the uselessness of intellectuals should find a different line of work. I’ve been a teacher, a political adviser, a subject-matter expert for both government and private industry, and a commenter on various media. I’m used to people disagreeing with me; in fact, I encourage it. Principled, informed arguments are a sign of intellectual health and vitality in a democracy. 

Rather, I wrote this because I’m worried. We no longer have those principled and informed arguments. The foundational knowledge of the average American is now so low that it has crashed through the floor of “uninformed,” passed “misinformed” on the way down, and is now plummeting to “aggressively wrong.” People don’t just believe dumb things; they actively resist further learning rather than let go of those beliefs. I was not alive in the Middle Ages, so I cannot say it is unprecedented, but within my living memory I’ve never seen anything like it...

Nichols, Tom (2017-02-01). The Death of Expertise: The Campaign Against Established Knowledge and Why it Matters (Kindle Locations 39-65). Oxford University Press. Kindle Edition.

FRIDAY UPDATE

I finished The Death of Expertise last night. I could not recommend it more highly. A bracing look at the difficulties we face combating willful ignorance.

...In the end, experts cannot demand that citizens pay attention to the world around them. They cannot insist people eat healthy meals or exercise more. They cannot drag citizens by the neck away from the latest reality television show and make them look at a map instead. They cannot cure narcissism by fiat. 

Tragically, I suspect that a possible resolution will lie in a disaster as yet unforeseen. It may be a war or an economic collapse. (Here, I mean a major war that touches America even more deeply than the far-away conflicts fought by brave volunteers, or a real depression, rather than the recession of the early twenty-first century.) It may be in the emergence of an ignorant demagoguery, a process already underway in the United States and Europe, or the rise to power of a technocracy that finally runs out of patience and thus dispenses with voting as anything other than a formality. 

The creation of a vibrant intellectual and scientific culture in the West and in the United States required democracy and secular tolerance. Without such virtues, knowledge and progress fall prey to ideological, religious, and populist attacks. Nations that have given in to such temptations have suffered any number of terrible fates, including mass repression, cultural and material poverty, and defeat in war...

Every single vote in a democracy is equal to every other, but every single opinion is not, and the sooner American society reestablishes new ground rules for productive engagement between the educated elite and the society they serve, the better. 

Experts need to remember, always, that they are the servants and not the masters of a democratic society and a republican government. If citizens, however, are to be the masters, they must equip themselves not just with education, but with the kind of civic virtue that keeps them involved in the running of their own country. Laypeople cannot do without experts, and they must accept this reality without rancor.
Experts, likewise, must accept that their advice, which might seem obvious and right to them, will not always be taken in a democracy that may not value the same things they do. Otherwise, when democracy is understood as an unending demand for unearned respect for unfounded opinions, anything and everything becomes possible, including the end of democracy and republican government itself. 

That, at least, is my expert opinion on the matter. I could be wrong. [The Death of Expertise, Kindle Locations 3621-3652]
See again the review at The Neurologica Blog (including the many comments).


MORE STUFF

From Wired:
Potential Trump Science Adviser Says Climate Change Is Great
...Scientists love nothing more than to question and shoot down each other’s results. But through those arguments, over time certain conclusions emerge. In this case, the balance of evidence shows that anthropogenic climate change is likely to alter the state of our environment significantly over the coming decades and centuries, and that these effects can be reduced by curtailing our greenhouse gas emissions. Yes, there are uncertainties in the details of the projections, but no reasonable risk assessment would use this as an excuse for not taking mitigating action. If you let your 6-year-old drive you to work tomorrow, there’s some chance you might both make it, but it doesn’t make it a good idea to give him the keys.

[Princeton physicist Dr. William] Happer’s potential appointment is in some ways more worrying than the administration’s hires to date, such as the appointee for EPA administrator Scott Pruitt, who simply denies scientific consensus on climate, making his position easy to dismiss in rational debate. Happer’s background in science and his selective consideration of the data give his opinions a veneer of respectability. If he is going to champion the principles of the scientific method and rational discourse, he must be able to defend his positions in the light of the overwhelming evidence for the significant risks associated with anthropogenic climate change. And that’s a fight he can’t win.
Below: This is a good fairly long read
How to Persuade a Trump Supporter to Reject and Resist Trumpism
A DIY Guide (v1.5) to Changing Minds Instead of Sending Your Sad Soliloquy or Smug Shouting Right into the Void
By an old-school rhetorician who thinks liberals, conservatives, radicals, and pretty much everyone desperately needs to improve their arts of persuasion and dialogue, who here posits that the loss of rhetorical skill and virtue contributed to the political hellscape that now engulfs us...
FEB 28th UPDATE

Just noted over at SBM:

Sharks get a lot of bad press and inspire a lot of fear, but in 2014 no one was killed by a shark in the US, while 36 people were killed by dogs, and 83 were killed by other mammals (including horses and cows). And tobacco kills a whopping 5.4 million people around the world every year.

Why do things that are unlikely to harm us get the most attention? In his new book Getting Risk Right, Geoffrey Kabat asks and answers that question. He says:

…we have been encouraged to worry about deadly toxins in baby bottles, food, and cosmetics; carcinogenic radiation from power lines and cell phones; and harm from vaccines and genetically modified foods… When looked at even the least bit critically, many of the scares that get high-profile attention turn out to be based on weak or erroneous findings that were hardly ready for prime time...
"Kabat has packed a wealth of information into his 180 pages of text, and everything he says is copiously supported by references. There is much to learn here, not only about the four subjects covered in depth, but about how science works and the factors that can lead us astray. This book will provide you with defensive armor against alarmist headlines and it will help you judge the credibility of new studies. Highly recommended."
Tee up another one in my Kindle reader.

OBAMACARE REPEAL

 

LOL.

MARCH 4TH UPDATE

Ran across an article this morning that led me to this book.


Fits with the topical theme of this post. From the Amazon blurb:
We’re surrounded by fringe theories, fake news, and pseudo-facts. These lies are getting repeated. New York Times bestselling author Daniel Levitin shows how to disarm these socially devastating inventions and get the American mind back on track. Here are the fundamental lessons in critical thinking that we need to know and share now.
Investigating numerical misinformation, Daniel Levitin shows how mishandled statistics and graphs can give a grossly distorted perspective and lead us to terrible decisions. Wordy arguments on the other hand can easily be persuasive as they drift away from the facts in an appealing yet misguided way. The steps we can take to better evaluate news, advertisements, and reports are clearly detailed. Ultimately, Levitin turns to what underlies our ability to determine if something is true or false: the scientific method. He grapples with the limits of what we can and cannot know. Case studies are offered to demonstrate the applications of logical thinking to quite varied settings, spanning courtroom testimony, medical decision making, magic, modern physics, and conspiracy theories.

This urgently needed book enables us to avoid the extremes of passive gullibility and cynical rejection. As Levitin attests: Truth matters. A post-truth era is an era of willful irrationality, reversing all the great advances humankind has made. Euphemisms like "fringe theories," "extreme views," "alt truth," and even "fake news" can literally be dangerous. Let's call lies what they are and catch those making them in the act.
May buy and read it as well. I've long been hip to Daniel Levitin's work. I have this one, below, in my Kindle stash. Read it some time back.


I am remiss for not having cited in in my prior post "Clinical workflow, clinical cognition, and The Distracted Mind."
____________

More to come...

Monday, February 20, 2017

#HIMSS17 in Orlando


I'm sure it will be interesting again, but I'm not attending this year. The uncertainty of my Jaco's looming demise was a major factor. Now that he's gone (sadly had to put him down Friday), I'm still heavy with mourning. He wasn't a "pet," he was a canine family member, a total delight. At 15 years old, he still had the rambunctious playfulness of a puppy. We were lucky to have found him in 2003 (on a freeway ramp in Las Vegas, about to be run over).


I'll just follow the HIMSS trade press reports like everyone else. Last time they held the show in Orlando was 2014. I was there. I first covered the HIMSS conferences in 2012, in Las Vegas (where I was living at the time, working for the Meaningful Use REC). The 2013 conference in NOLA was great fun. As was the 2016 conference, back in Las Vegas.

Next up for me on the conference front will be this year's "AARP Innovation 50+" event, which has expanded from a one-day conference to two days.

Will continue this week with my "STEM the Denialism" effort, and try to get caught up on my endless reading.

Also, visit the excellent new site "Calling Bullshit."

"What do we mean, exactly, by the term bullshit? As a first approximation, bullshit is language, statistical figures, data graphics, and other forms of presentation intended to persuade by impressing and overwhelming a reader or listener, with a blatant disregard for truth and logical coherence.

While bullshit may reach its apogee in the political domain, this is not a course on political bullshit. Instead, we will focus on bullshit that comes clad in the trappings of scholarly discourse. Traditionally, such highbrow nonsense has come couched in big words and fancy rhetoric, but more and more we see it presented instead in the guise of big data and fancy algorithms — and these quantitative, statistical, and computational forms of bullshit are those that we will be addressing in the present course."
___

HIMSS17 "INTEROPERABILITY"


FIRST KEYNOTE
 

CLOSING REMARKS

 

Interesting. She says that HIMSS18 will be again back in Las Vegas.

I searched the HIMSS17 news every day this week. Didn't see much beyond the usual corporate press release re-writes. The industry looks quite healthy (HIMSS, an $80+ million a year "non-profit" business, certainly is), but "transformational" IT innovations seem to be sparse at this point.

Uncertainties surrounding looming Trump administration / GOP policy reforms seem to be key this year.

I'd have certainly attended this:

US HEALTHCARE REFORM EFFORTS: NOW AND INTO THE FUTURE
February 21, 2017 — 02:30PM EST - 03:30PM EST
Orange County Convention Center
W320, Chapin Theater
Session ID: 133


Description
This session calls on two health policy experts for a discussion on the Affordable Care Act (ACA) and efforts underway to implement reforms to our healthcare system.  The current state of ACA implementation will be discussed as well as what issues need to be addressed in “repeal and replace” scenarios currently being considered in the US Congress as well as well as the Trump Administration.  Attendees can expect to gain knowledge on the critical health reform issues and outcomes being discussed by both Republicans and Democrats.
Speaker(s): 


Jonathan Gruber, PhD
Yevgeniy Feyman
Gruber, 'eh? Press report of the session:
Policy Experts Explain the Trouble with Repeal and Replace
February 22, 2017 | Healthcare Reform
By Gabriel Perna


Repeal and replace is easier said than done.

present, and future of the Affordable Care Act (ACA) this week at the annual Healthcare Information and Management Systems Society (HIMSS) conference, held in Orlando.

Jonathan Gruber, Ph.D., professor of economics at Massachusetts Institute of Technology and ACA architect with the Obama administration, was joined by Yevgeniy Feyman, a fellow at the Manhattan Institute, a policy research organization, to give an overview of the challenges in repealing and replacing the health law. They also discussed the merits of the ACA, a collapse of the insurance market, and much more in an hour-plus session.

Gruber didn't mince words when asked to predict the road ahead for an ACA replacement. "It was a hard process to pass the Affordable Care Act. It was a year-plus process with a filibuster majority. I honestly don't see a replacement. I don't see how Republicans get enough Democrats to switch over, [and] not filibuster the law. You can't replace through direct reconciliation, you can repeal, but not replace. I honestly don't see it replaced," Gruber said.

Feyman was a little less skeptical, saying the plan proposed by Senators Susan Collins (R-Maine) and Bill Cassidy (R-La.), which allows states to go their own way with the ACA is potentially more "palatable." However, he also said he didn't think a repeal was going happen as enough Republicans will get on board.

The fact that every replacement plan proposed by Republican congressmen increases the uninsured is a significant roadblock, Gruber said, adding that repealing the law outright would cause 32 million to lose health coverage. There are 20 million who picked up insurance through the law and 12 million more through a collapse of the insurance market, he said. He also noted that insurance premiums would double.

"This is what the [Congressional Budget Office] said, this is not biased Jon Gruber," he said. The CBO predicted that the elimination of the Medicaid expansion and insurance subsidies would cause up to 32 million to lose coverage by 2026...
Interesting news coverage all week of numerous GOP "town hall" constituent meetings replete with angry people now flipping out over the realization that they may soon be without health insurance. But, hey, House Speaker Paul Ryan will "Put patients back in control of their health care." HSA's, vouchers, block grants, problem solved.

Meanwhile, Mr. Speaker will continue to avail himself of his 70% subsidy, generous FEHB program.
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NEUROBABBLE UPDATE

Interesting book review over at SBM:
Daniel and Tana Amen’s Book The Brain Warrior’s Way: Standard Health Advice Mixed with Misinformation and Fanciful Ideas
Daniel Amen, the media-savvy psychiatrist and promoter of SPECT scans, has teamed-up with his wife Tana to write a self-help book that hopelessly muddles good medical advice with misinformation and speculation
So much neurobabble, so little time. SBM is a great site.

@Health2con update
A Million Jobs in Healthcare’s Future
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More to come...

Tuesday, February 14, 2017

Next up, STEM the Denialism

It has been a difficult week at my house. My terminally ailing elder dog Jaco may die or have to be put down at any time. I slept in fits and starts last night on the couch in the family room staying close by. We all know here that time is short. Keeping up with my reading, but I'm not getting much done at the keyboard.

In support of The March for Science effort and its important larger long-term purpose, I'm probably gonna start a new blog dedicated specifically to those issues. And will probably open it to co-contributors. Let me know if you're interested. bobby[dot]gladd[at]comcast[dot]net.




FRIDAY 17th UPDATE

My precious Jaco is gone. Had to have him put down today. Crushingly sad.


SATURDAY UPDATE

Morose here today. Carlos (my other dog) is confused. Where's his Big Bro'? I am struggling to accept Jaco being gone. I shall miss him terribly.

Just in, a new academic effort I saw reported over at STATnews:

The world is awash in bullshit. Politicians are unconstrained by facts. Science is conducted by press release. Higher education rewards bullshit over analytic thought. Startup culture elevates bullshit to high art. Advertisers wink conspiratorially and invite us to join them in seeing through all the bullshit — and take advantage of our lowered guard to bombard us with bullshit of the second order. The majority of administrative activity, whether in private business or the public sphere, seems to be little more than a sophisticated exercise in the combinatorial reassembly of bullshit...
From the FAQ page:
Why are you doing this?
As we explain on our home page, we feel that the world has become over-saturated with bullshit and we're sick of it. However modest, this course is our attempt to fight back.

We have a civic motivation as well. It's not a matter of left- or right-wing ideology; both sides of the aisle have proven themselves facile at creating and spreading bullshit. Rather (and at the risk of grandiose language) adequate bullshit detection strikes us as essential to the survival of liberal democracy. Democracy has always relied on a critically-thinking electorate, but never has this been more important than in the current age of false news and international interference in the electoral process via propaganda disseminated over social media...
Their course syllabus page.

Cool. Yeah, See, e.g., Dr. Frankfurt's book "On Bullshit."
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More to come...

Wednesday, February 8, 2017

Neurobabble update

I've had my sport here before with poseurs claiming to traffick beneficently in applied commercial "neuroscience." Recall these tweets.


Ahhh.... Jim Kwik, Mr. "I Build Better Brains." Then there's the jovial self-proclaimed neuro-musicology "scientist" Will Henshall.

Now comes "Neurocore Brain Centers" "Boost Your Brain Power in 2017."

Lordy. I've reached out to them repeatedly to no avail, asking for independent documentation of the underlying neuroscience upon which their "therapy" is ostensibly based. They're not gonna respond to some piss-ant ankle-biter like me. The temerity!
Their basic summary pitch:
The Neurocore Brain Performance Center Experience
At our Brain Performance Centers, we look past labels and assumptions to uncover the root cause of your symptoms. Based on your unique brain map, we create a personalized program to help you train your brain to its optimal performance. It’s safe and drug-free.


Brain Diagnostics
Rather than acting solely on observed behaviors, Neurocore takes a scientific approach to understand what’s wrong. Your comprehensive assessment includes brainwave analysis using qEEG technology, heart rate and breathing analysis and other diagnostic tests to paint a clear picture of what’s going on in your brain.

Customized Program
Once your brain shows us what is causing the problem, your unique brain map becomes our guide to designing a personalized treatment program. Through positive reinforcement and repetition, neurofeedback sessions train your brain to function better, more efficiently – so you feel better.

Lasting Results
Over time, your symptoms recede and in many cases disappear. This is unlike medication, which simply masks your symptoms until it wears off and it's time for the next dose. At Neurocore, we fix the problem, not just cover it up. Our drug-free solution lasts beyond each treatment session and can provide benefits to your brain and life for years to come.
Watch their "overview" video clip here.


That's a broad list of clinical conditions.

Turns out that Neurocore's principal investor is the controversial newly-confirmed Trump Administration Secretary of Education Betsy DeVos.
DeVos-Backed Company Questioned on ADHD, Autism
Neurocore touts its autism, ADHD treatment

By Benjamin Herold •February 7, 2017
President Donald Trump's nominee to head the U.S. Department of Education is a major backer of a company claiming its neurofeedback technology can "fix" problems such as attention deficit hyperactivity disorder and has "proven and long-lasting" positive effects on children with autism.

Current scientific evidence does not support such claims, according to the clinical guidelines of the American Academy of Pediatrics and three leading researchers Education Week consulted.

"It's misleading the public to say neurofeedback is effective in treating kids with ADHD and autism," said Nadine Gaab, an associate professor of pediatrics at Boston Children's Hospital and a faculty member at the Harvard Graduate School of Education. "It's still an experimental treatment that needs more rigorous research."

Launched in 2006, Neurocore is based in Grand Rapids, Mich. That's also the hometown of billionaire school choice advocate Betsy DeVos, Trump's pick to become U.S. secretary of education.

DeVos sat on Neurocore's board from 2009 until November, when she resigned the position to avoid potential conflicts of interest should she be confirmed. As part of her divestiture plan, which has been approved by the federal Office of Government Ethics, DeVos and her husband, Richard DeVos, Jr. , will maintain an indirect financial interest in the company. On her disclosure forms, DeVos valued that stake at between $5 million and $25 million.
...A spokesman for the DeVos family declined to respond to Education Week's inquiries about the investment in Neurocore. The Trump administration did not respond to Education Week's request for comment.

Neurocore CEO Mark Murrison defended his company's work and marketing. He pointed to an emerging body of research in which neurofeedback in general has shown promise, as well as information Neurocore collects from its clients.

"What we provide to our clients truly makes a difference, and our internal outcomes data and testimonials bear that out," Murrison said in an interview...
"Internal outcomes data and testimonials?"

...Murrison, Neurocore's CEO, acknowledged that there have to date not been any such high-quality studies conducted about Neurocore specifically. The first peer-reviewed study of the company's outcomes, for clients with anxiety and depression, "should be going to press in the next few months," he said. Another peer-reviewed study of Neurocore's impact on clients with ADHD is in the works, according to Murrison...
Yeah, I'll hold my breath.

The internet wags have wasted little time.
"Education Secretary Betsy DeVos Unveils Common NeuroCore Standards"
LOL. "Neurobabble." How about "NeuroPractic?" "NeuroQuackery?" (my irascible reactions)

I hope the good folks at Science Based Medicine will give this a go. Other media outlets are starting to chime in. See, e.g., "Betsy DeVos-Backed Doctor Says TV Can Remedy Attention Deficit Disorder."  

NY Times is also on it. "Betsy DeVos Invests in a Therapy Under Scrutiny."
“Is it time for a mind makeover?” the company asks in its advertising. “All it takes is science.”

But a review of Neurocore’s claims and interviews with medical experts suggest its conclusions are unproven and its methods questionable.


Neurocore has not published its results in peer-reviewed medical literature. Its techniques — including mapping brain waves to diagnose problems and using neurofeedback, a form of biofeedback, to treat them — are not considered standards of care for the majority of the disorders it treats, including autism. Social workers, not doctors, perform assessments, and low-paid technicians with little training apply the methods to patients, including children with complex problems...


Neurocore lists 40 "scientific papers" on their "learn more" page. Critics have countered that these window-dressing citations go to various aspects of neuroscience in general, but none go to the company's internal controlled trial studies.

Because, by the CEO's admission above, there aren't any to date. At this point, all we have is "neurobabble." Whether we get to "neuroquackery" remains to be seen.

ERRATUM

Join the March for Science. See my prior post "Update on the March for Science"
and the antecedent "I am not a scientist."

Just in: Feb 9th War on Science update:
The Backpedaler-in-Chief
The Trump administration has retracted its most alarming anti-science moves. Is that heartening or a sign of more disturbing policies to come?
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On science and "transparency." The Theranos VC lesson.


In this regard, see "Bill Maris: Here's why Google Ventures didn't invest in Theranos."

NEW BOOK

One of three new ones I have going at the moment, actually.


Gloriously written. Stay tuned. The other two are here and here.

SOME PAINFUL PERSONAL NOTES

About a month ago our precious 15 yr old rescue dog Jaco was diagnosed as "terminal" with a number of tumors in his liver. Absent "exploratory surgery" (which the vet said would be a coin-flip in any event), he's expected to die soon, or have to be put down should he get really bad.


It's been day-to-day, sometimes hour-by-hour ever since. Several times I though he was dying or already gone. Once I determine he's in significant pain, I will have him euthanized, but we're not there yet -- apparently. There's no good way to tell.

Trying to give him "A Good Death," but, well, you know...

Also, two days ago, my dear friend Kurt Kolstad finally succumbed, losing his 11-year struggle against mantle cell lymphoma. We are all distraught. As I posted on my Facebook page:
My dear friend of 43 years, Kurt Kolstad, has finally succumbed after an excruciating 11 year battle with mantle cell lymphoma. I am really heartbroken today. Kurt was one of the best drummers in the world. Period. He could've played for Sting. He also played guitar, and keyboard, and wrote great songs. Beyond all that, he was a wonderful human being. I was blessed to share a stage with him up in the Seattle area many years ago. While I am glad his suffering is finally over, I will miss him sorely. http://bgladd.com/KurtKolstadSuddenSamba.mp3
He began his illness with pre-ACA health insurance,written through his wife's employer. He maxed out the policy and they lost coverage. Then they lost their home to foreclosure. THEN, not quite four years ago kurt's wife Cyndy died. I got there as soon as I could. I posted a YouTube clip:
My dear friend Kurt, who has been fighting off Mantle Cell Lymphoma for 8 years, lost his wife Cyndy 48 hours ago. I'm over at his place in Tacoma. I started singing "Lean on me," which spurred him. "Let me play for ya this tune I wrote 4 years ago. It's my "Lean on me'. It's on a CD out in the car."

This is off my iPhone. BobbyG's Left Hand Unsteady Cam Productions.

Self-explanatory. This glorious musician-writer (with whom I shared a stage 39 years ago) and his family have been reduced to crushing penury by nearly a decade of acute, life-threatening illness. Now with personal tragedy piled atop it.
Very sad time here of late.
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More to come...

Thursday, February 2, 2017

Update on The March for Science

Recall my prior post "I am not a scientist." 

In my inbox this morning.

Hello!

We are overwhelmed and grateful at the incredible support we've had in organizing this march. In the last week, almost 40,000 people have reached out to us eager to help.

We want to thank you so much for your support of the March for Science — and for you patience while we secured permits and coordinated with sister marches.

The March for Science is a celebration of our passion for science and a call to support and safeguard the scientific community. 

On April 22, 2017, scientists and science enthusiasts will take to the streets.

We will be reaching out to you for volunteer help in the coming weeks — we look forward to collaborating with you on outreach, planning events, fundraising, developing apps, brainstorming next steps, orchestrating satellite marches, and improving the world through science!

Satellite marches are being formed in countries across the globe from Canada to Australia. In Washington DC, our march will lead to a rally on the Washington Mall where scientists will hold teach-ins about their work and how science impacts our every day lives. Scientific discovery can be an arduous process, but it's also fun — it's time we share that excitement with the world!

The March for Science Team
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I was beginning to wonder. I put in to volunteer straight away, but never heard anything in response.

They've now mounted a web page.


Twitter, Facebook, and Instagram links there. Hashtag #marchforscience.

Nice "diversity" statement:
In the past days, scientists have voiced concern over many issues - gag orders for government science agencies, funding freezes, and reversing science based policies. We recognize that these changes will differently and disproportionately affect minority scientists, science advocates, and the global communities impacted by these changes in American policies. Addressing these issues is imperative in understanding how recent developments will affect all people - not simply the most privileged among us. We take seriously your concerns that for this march to be meaningful, we must centralize diversity of the march's organizers at all levels of planning. Diversity must also be reflected in the march itself - both through the mission statement and those who participate.

At the March for Science, we are committed to highlighting, standing in solidarity with, and acting as allies with black, Latinx, Asian and Pacific Islander, indigenous, Muslim, non-Christian, non-religious, women, people with disabilities, poor, gay, lesbian, bisexual, queer, trans, non-binary, agender, and intersex scientists and science advocates. We must work to make science available to everyone and encouraging individuals of all backgrounds to pursue science careers, especially in advanced degrees and positions. A diverse group of scientists produces increasingly diverse research, which broadens, strengthens, and enriches scientific inquiry, and therefore, our understanding of the world.
Indeed.

I would gladly go and attend the DC march (I could see and stay with my son at his house in Baltimore), but I am also quite willing to help establish and participate in a Bay Area march. I will be making a donation as well.

See also the related ScienceDebate.org.

I again call attention to some excellent reading going to the central issues.


The first four comprise a compelling tour from the Big Bang to today's troubling Anthropocene era. The latter three go to issues of science denial and effective, potentially "disruptive" communication in a digital age. I've cited them before. All highly recommended.

Shawn Otto's book The War on Science dwells in particular on three areas of front-burner policy contention: [1] evolution, [2] climate change, and [3] human reproductive rights (long under attack, but increasingly so of late).

"Science Denialism" runs rampant on the first two. My position on the latter, politically radioactive topic has been set forth in some detail on one of my other blogs. See my 2008 post "Diploid Dave, Zelinda Zygote."

Shawn Otto:
When Does Life Begin? Another example of the thorny intersection of science with traditional ideas, law, and politics comes from the biosciences. Careful, reproducible observations and measurements have forced us to repeatedly refine our ideas about what life is and when it begins. Is a human being first a life when it emerges from the birth canal? Does it have any legal rights as a person before then? Or is it a life when it is able to survive independently outside of the womb even if it is removed early, as can happen naturally with premature birth or with a Caesarean section? Or is it perhaps a life at quickening (the moment a mother first feels a fetus move, at about four months), as was the legal standard for a life when America was formed? But wait! Perhaps it is really a life when a fertilized egg first implants in the uterine lining, which, based on observations, is the medical definition of when a pregnancy begins. A woman cannot be said to be pregnant until her body begins the chemical and biological changes that accompany a symbiotic hosting of the embryo, can she? If it does not implant, the egg, even if fertilized, is simply flushed. Here we get into a tricky area, because many religious conservatives say, “No, it is a life when egg and sperm meet,” whether or not the fertilized egg ever implants. 

But then, a scientist would ask the fundamentalist, is it still a life at the moment of fertilization, even if we know from careful observation that one-third to one-half of fertilized eggs never implant, and as many as three-quarters fail to lead to an ongoing pregnancy? And, of course, that brings up more questions: What are fertilized eggs that never implant? How should we define them, if life occurs at fertilization? As miscarriages? Abortions? Nonpregnancies? Suicides? Murders? Something else? What implications might that definition have— legally, ethically, morally— for the use of birth-control pills that inhibit implantation? Is that abortion, murder, or pregnancy prevention? 

As our careful observations of life continue, so does our power both to assist and prevent pregnancy. But as our skills improve, new, more troubling questions form. What if we remove the uterus from the process entirely? Is it a life when sperm and egg are joined in a test tube at a fertility clinic and allowed to divide into a group of, say, sixteen cells that are then frozen for future implantation in a woman desperate to have children? Can the woman be said to be “pregnant” as long as this microscopic clump of frozen cells exists? What does Burwell v. Hobby Lobby Stores say about that? What, if any, rights should these frozen cells possess? And is a child conceived in this way— a “test-tube baby,” as we once called them— without a soul, as was suggested by some religious conservatives in the 1970s? Once born, are the joy they bring and the contributions they make less valuable? If we make a special exception for them, by agreeing that in vitro fertilization is not interfering with God’s plan, or by acknowledging that they do appear to have souls, why? On what basis? And what does that make the dozens of frozen cells we discard after a successful pregnancy? 

While we’re pondering these linguistic, legal, and ethical quandaries, our observations lead us to yet another new understanding. We don’t need sperm to fertilize an egg; we can do it with the nucleus of another cell from the same being. We try this, and sure enough, we find we can create many identical genetic copies of a sheep or mouse. We call them clones. But then we have to ask: Is it a life if it is just an ovum that has had its nucleus removed and replaced by the nucleus of another cell, and has then been chemically or electrically shocked to induce the natural process of cell division, without fertilization by sperm? If egg and sperm have never met, is it a life? Or is that creature— possibly, one day, a human— damned or soulless as it was once argued “test tube babies” would be? 

Observations tell us that beings produced in nontraditional ways seem to be the same as any other creatures. We have to ask, then, is every one of the roughly 1.5 million eggs a woman has in her ovaries at birth a life with rights? When, exactly, does life begin? Is it true, as the comedy troupe Monty Python sang in The Meaning of Life, that “every sperm is sacred”? 

What happens if we transform adult skin cells into stem cells, and those into sperm and egg, and then fertilize one with the other? Is that a clone or something else? What if we take the troublesome term “fertilization” out of the picture? Is it a life if we design its genome on a computer (as scientists at the J. Craig Venter Institute have done), buy a high-quality DNA synthesizer on eBay for $ 8,000 or so, use it to make fragments of the genome we designed, chemically stitch the fragments together, inject the complete genome into a cell with an empty nucleus, and shock it into replicating? Here, we have made a living, reproducing thing starting with a computer design and a few common chemicals. What does that mean for our ideas about life and our definition about conception? Is it wrong to be doing this? To be asking these questions? Applying these observations? Gaining these powers? 

What is life? Is life an unbroken chain of genetic code, running down through the generations, endlessly recombining in new forms? Is it software? Does the software beget the hardware? When does it become an individual with rights? Where do we draw the legal line? The moral line? Can we draw a line at all? Is that the right way to be thinking about it? And if we do, how do we define the terms conception, fertilization, implantation, and pregnancy?
Otto, Shawn Lawrence (2016-06-07). The War on Science: Who's Waging It, Why It Matters, What We Can Do About It (Kindle Locations 1120-1164). Milkweed Editions. Kindle Edition.
"When does life begin?"

The (soon likely to be again pressing) Constitutional question is "when does personhood begin?"

I'm not sure "science" can answer that. It can help inform the answer, but the answer will necessarily come from serious, difficult moral deliberation. Serious deliberation, not the preening clean-hands moral dilettantism that seems to be at the anti-choice activist policy fore.

THE "PETITION"
"Given the many urgent scientific and technological challenges facing America and the rest of the world, the increasing need for accurate scientific information in political decision making, and the vital role scientific innovation plays in spurring economic growth and competitiveness, we call for public debates in which the U.S. presidential and congressional candidates share their views on the issues of science and technology policy, health and medicine, and the environment."
I never sign online petitions, because you typically end up as a Mark, with your info sold to fundraising hucksters. I'm making an exception this time.

UPDATE

Rational reasoning and truth have been much on my mind as we enter a world of alternative facts and crypto-fascist edicts from the White House, less than two weeks into Donald Trump’s Administration. Last week, when “1984” rose toward the top of Amazon’s best-seller list, I dug out my dog-eared paperback copy and reread a quotation that I had underlined a decade and a half earlier: “For, after all, how do we know that two and two make four? Or that the force of gravity works? Or that the past is unchangeable? If both the past and the external world exist only in the mind, and if the mind itself is controllable—what then?”

In recent days, as Trump and his cohorts have peddled blatant falsehoods—that his Inauguration attracted the largest crowd in history, or that he lost the popular vote owing to millions of votes by illegal aliens—I have wondered about the extent to which minds can be controlled, or, rather, commandeered, by the relentless deluge of misinformation...


The muddling of fact and fiction is a tried-and-true tactic of totalitarian regimes. What’s more, when the two are confused for long enough, or when an indefatigable war on truth has been waged for a year, or two years, or perhaps eight, it will likely be harder and more tiresome to untangle them and remember a time when a firm line was drawn between the true and the false as a matter of course. If amnesia breeds normalization, fatigue has always served as the authoritarian’s great accomplice...

In the next four to eight years, American children will be born in a country led by a vainglorious man who wishes to fit facts—and their future—into the convenient shape of his ego. But democracy, freedom of expression, and, above all, the right to truth are not antiquated pieties. They belong to citizens who can still make their voices heard, before resignation metastasizes into complacency, exhaustion into self-doubt. The struggle will be to maintain openness and tolerance as the norm, the values that our children absorb into their identities naturally—to be defended rather than be defensive about...
- Jiayang Fan
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UPDATE: SOME NOTES ON TRUMP'S "EXTREME VETTING" 

Fear-mongering and otherwise pandering authoritarian irrationality extends to policy areas beyond explicit science topics such as climate change, evolution, and reproductive biology. Take, for example, the current dust-up over Trump's Executive Order immigration ban and his methodologically / operationally TBA promise of "extreme vetting." I'd call it "Total Information Awareness 2.0."

I've written on this topic elsewhere as well. After the GW Bush administration proposed a "Total Information Awareness" panoptic surveillance initiative in the wake of 9/11, I posted a web page entitled The Homeland Security Act and the proposed DARPA "Total Information Awareness" (TIA) program. (Probably a good bit of 'link rot' on that 15 yr old old thing. BTW, I had a bit of sport with the TIA Director here. Yes, I actually sent that via snailmail.)

I expanded on that riff in a more comprehensive 2008 blog post entitled Privacy and the 4th Amendment amid the "War on Terror."

Among other things, you're hemmed in by Bayes. Prevalence matters. Technologically, the gumshoe real world is not yet "The Bourne Ultimatum."
 
UPDATE: MARCH FOR SCIENCE SAN FRANCISCO FACEBOOK GROUP


Just joined. Group link here. There's also a Twitter group. One of an increasing number, it would seem. #MarchForScience

FEB 3RD UPDATE, "EXTREME VETTING"
BUT WAIT! THERE'S MORE!

Via my now-daily email newsfeed from Scientific American:
PUBLIC HEALTH
Trump Immigration Ban Can Worsen U.S. Doctor Shortage, Hurt Hospitals
Thousands of U.S. physicians and medical students from banned countries may leave hospitals without staff 


The U.S. could face a shortfall of thousands of doctors, experts warn, because Pres. Donald Trump issued an executive order last week that banned citizens of seven majority-Muslim countries from entering the U.S. for 90 days. The order has created fears among foreign-born doctors and medical students—more than a quarter of the physician workforce in the U.S. comes from other countries, including Syria and Iran—that they will be persecuted in the U.S. or forced to leave. Medical school leaders say that sought-after applicants are likely to move their careers to other countries...
The Stupid. It burns.

UPDATE: Michael Specter nails it in The New Yorker, "The Deep Denialism of Donald Trump."
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More to come...