Wednesday, May 27, 2015
Friday, February 21, 2014
Since my last post, I've gotten married, I now have a year and a half year old son and have been working hard in my surgical residency - which I am just now starting to see the light at the end of the tunnel. Suffice it to say that my recent life has seriously curtailed my elective reading.
Anyway, back to the topic at hand. I liked the book for the most part. Besides for one odd chapter where he seem to tangentially go off on Francis Collins, Sam Harris does a good job defending the concept of a secular objective basis for morality. He does this by identifying the common values of humanity being human flourishing and wellbeing and that there are acts and social policies, etc, that objectively either progress or regress on those goals. Morality is then that which moves us towards greater human wellbeing; immorality that which moves us further from it.
Here's Harris giving the general argument in a TED talk:
It also helps that before my hiatus I had made some very similar arguments on my own. Much of my discussions were found on the now defunct blog of XGH, but as I wrote in the comments of this blogger post from 2009:
"Morals are made in response to human nature and the human condition - objective facts. People may disagree on methods and mechanisms but the goals are always to do what is in the best interests of man. And unless you believe all interests are equally rational and valid, i.e. to eat an apple is as valid a choice as is swallowing a gallon on bleach, then you must recognize a hierarchy of objectively correct decisions: that some acts, some moral codes, make more sense than others. The value of human life makes sense whereas it's non-value is self-defeating.
With that recognition and the assumed goal that rules be made to lead to the best interests of man then it becomes potentially able to be studied scientifically - objectively. Does a given moral in a given society lead to the wellbeing of man in that society? By the mere process of evolution of human civilization, we have already learned how a great deal of once-idealized moral behavior is in fact counterproductive."
Of course different people can converge on similar ideas, but it makes you wonder if Harris was a Jblog fan himself...
Wednesday, June 09, 2010
What Happened Before the Big Bang?
By Paul Davies
It is often said that science cannot prove the existence of God. Yet science does have value in theological debate because it gives us new concepts that sometimes make popular notions of God untenable. One of these concerns the nature of time.
Many people envisage God as a sort of cosmic magician who existed for all eternity and then, at some moment in the past, created the universe in a gigantic supernatural act. Unfortunately, this scenario raises some awkward questions. What was God doing before he created the universe? If God is a perfect, unchanging being, what prompted him to act then rather than sooner?
The fifth-century theologian St. Augustine neatly solved the problem by proclaiming that the world was made with time and not in time. In other words, time itself is part of God's creation.
To make sense of Augustine's concept, it is necessary to place God outside of time altogether, and the notion of a timeless Deity became official church doctrine. However, it is not without its own difficulties. How can a timeless God be involved with temporal events in the universe, such as entering into human history through the Incarnation?
Today, religious people like to identify the creation with the Big Bang of scientific cosmology. So what can we say about the nature of time in the scientific picture?
Albert Einstein showed us that time and space are part of the physical world, just as much as matter and energy. Indeed, time can be manipulated in the laboratory. Dramatic time warps occur, for example, when subatomic particles are accelerated to near the speed of light. Black holes stretch time by an infinite amount. It is therefore wrong to think of time as simply "there," as a universal, eternal backdrop to existence. So a complete theory of the universe needs to explain not only how matter and energy came to exist, it must also explain the origin of time.
Happily, Einstein's theory of relativity is up to the job. It predicts a so-called "singularity" at which time abruptly starts. In the standard Big Bang scenario, time and space come into being spontaneously at such a singularity, along with matter.
People often ask, What happened before the Big Bang? The answer is, Nothing.
By this, I do not mean that there was a state of nothingness, pregnant with creative power. There was nothing before the Big Bang because there was no such epoch as "before." As Stephen Hawking has remarked, asking what happened before the Big Bang is rather like asking what lies north of the North Pole. The answer, once again, is nothing, not because there exists a mysterious Land of Nothing there but because there is no such place as north of the North Pole. Similarly, there is no such time as "before the Big Bang."
Of course, one can still ask why a universe popped into existence this way. Cosmologists believe the answer lies with the weird properties of quantum mechanics, a topic beyond the scope of this essay.
We can now see that Augustine was right, and popular religion wrong, to envisage God as a superbeing dwelling within the stream of time prior to the creation. Professional theologians acknowledge this. The doctrine of creation ex nihilo (out of nothing) does not mean God pushing a metaphysical button and making a Big Bang, then sitting back to watch the action. It means God sustaining the existence of the universe, and its laws, at all times, from a location outside of space and time.
Can science give any credibility to such a notion? Mostly, scientists either are atheists or keep God in a separate mental compartment. However, there is a strong parallel in the scientific concept of the laws of nature. Like the theologians' God, these laws enjoy an abstract, timeless existence and are capable of bringing the universe into being from nothing. But where do they come from? And why do these laws exist rather than some different set?
Science is based on the assumption that the universe is thoroughly rational and logical at all levels. Miracles are not allowed. This implies that there should be reasons for the particular laws of nature that regulate the physical universe. Atheists claim that the laws exist reasonlessly and that the universe is ultimately absurd. As a scientist, I find this hard to accept. There must be an unchanging rational ground in which the logical, orderly nature of the universe is rooted. Is this rational ground like the timeless God of Augustine? Perhaps it is. But in any case, the law-like basis of the universe seems a more fruitful place for a dialogue between science and theology than focusing on the origin of the universe and the discredited notion of what happened before the Big Bang.
Thursday, April 29, 2010
Answer: A medical student has the same halachic coverage as a house staff physician or attending physician.
Comment: Although the student has no legal responsibility for patient care, and although he may not have adequate knowledge to exercise mature medical judgment, his aid is often necessary and nearly always beneficial. Time is saved by the senior physician because additional hands are available. The halacha does not distinguish between medical student, clinical clerk, resident, and attending physician, or even layman, insofar as all contribute to the total patient care. The obligation to aid a dangerously ill patient falls not only on the graduate physician but on anyone able to and asked to render assistance. Included in this obligation are first- and second-year medical students and certainly third- and fourth-year students who possess considerable medical knowledge and are essential members of the diagnostic and therapeutic team... [A] medical student has the same halachic coverage as the graduate physician, including laws pertaining to the Sabbath and Yom Tov."
From: "Practical Medical Halachah" by Dr. Fred Rosner and Rabbi Moshe D. Tendler, 1997, page 15.
Sunday, March 21, 2010
-The Mandans: a study of their culture, archaeology and language, Volume 3 By George Francis Will, Herbert Joseph Spinden, page 140
"The Mandans (people of the pheasants) were the first people created in the world2, and they originally lived inside of the earth; they raised many vines, and one of them had grown up through a hole in the earth overhead, and one of their young men climbed up it until he came out on top of the ground, on the bank of the river, where the Mandan village stands. He looked around, and admired the beautiful country and prairies about him—saw many buffaloes—killed one with his bow and arrows, and found that its meat was good to eat. He returned and related what he had seen, when a number of others went up the vine with him. and witnesseth the same things. Amongst those who went up, were two very pretty young women, who were favorites with the chiefs, because they were virgins, and amongst those who were trying to get up, was a very large and fat woman, who was ordered by the chiefs not to go up, but whose curiosity led her to try it as soon as she got a secret opportunity, when there was no one present. When she got part of the way up, the vine broke under the great weight of her body and let her down. She was very much hurt by the fall, but did not die. The Mandans were very sorry about this, and she was disgraced for being the cause of a very great calamity, which she had brought upon them, and which could never be averted, for no more could ever ascend, nor could those descend who had got up;. but they build the Mandan village, where it formerly stood, a great ways below on the river; and the remainder of the people live under ground to this day.'" -
-< -->South Dakota historical collections, Volume 4 By South Dakota State Historical Society, South Dakota. Dept. of History, page 521
"The Numangkake [aka Mandan] now resolved to go up. The great chief with his medicine and his schischikue in his hand, went first. They climbed up, one after another by the aid of a branch of a vine; and when exactly half their number had ascended, and a corpulent woman was half way up the vine, it broke, and the remainder of the nation fell to the ground. This happened in the neighborhood of the sea shore. Those who had reached the surface went on till they came to the Missouri, which they reached at White Earth river. They then proceeded up the Missouri to Moreau's river. At that time they knew nothing of enemies. Once, when a Mandan woman was scraping a hide, a Cheyenne Indian came and killed her. The Mandans followed the traces of this new enemy till they came to a certain river, where they all turned back with the exception of two, the husband and the brother of the woman who was killed. These two men went on till they discovered the enemy, killed one of them and took his scalp with them. Before they got back to their village they found some white clay which they had never seen before, and took a portion of it with them. When they came to their great chief, the first man who had climbed up the vine, and whose skull and schischikue they still preserve, as a relic, in the medicine bag of the nation, they gave him the white clay, with which he marked some lines on his schischikue. The name of this chief was, at first, Mihti-Pihka (the smoke of the village), but when he ascended to the surface of the earth he called himself the Mihti-Shi (the robe with the beautiful hair). When he had received the clay and the scalp, he commanded all his people to shoot buffalos, but only bulls, and to make shields of the thickest part of the hide, which they did. When this was done, they asked the chief what were his next commandments. To which he replied, 'Paint a drooping sunflower on this shield' (as a sort of medicine or amulet), on which the sister of the chief said, 'You are fools; paint a bean on it; for what is smoother than a bean to ward off the arrows.'
"The chief now introduced the establishment of the bands or unions, and founded first that of 'the foolish dogs.' He made four caps of crows' feathers, and commissioned the Mandans to make a number of similar ones. He then gave them the war pipe and song, and exhorted them to be always valiant and cheerful, and never to retreat before the point of the arrow. He also gave them the strips of red cloth which hang down behind, and added that, if they would follow his directions, they would always be esteemed as brave and worthy men. The chief then made two of the bent sticks covered with otter skins, and gave them the kanakara-kachka. and then two others adorned with raven's feathers^ which he also presented to them. The first represent the sunflower, and the latter the maize. 'These badges,' said he, 'you are to carry before you when you go against the enemy; plant them in the ground, and fight to the last man, that is to say, never abandon them.' He next founded the band of 'the little foolish dogs,' and assembled many young men. whom he ordered to paint their faces of a black color, and gave them a song of their own, with the war whoop at the end. and said he would call them the 'black-birds.' He afterwards went to war with his people against the Cheyennes. They reached the enemy and laid all their robes in a heap together. The chief wore a cap of lynx skin, and had his medicine pipe on his arm. He did not join in the action, but sat apart on the ground during the whole time that it lasted. They fought almost the whole day, drove the enemy into their village, and were then repulsed, which happened three or four times, and one of the Numangkake was killed. When the chief was informed of this, he ordered them to go to the river and bring a young poplar with large leaves, which he planted in the ground near to the enemy, and challenged the Cheyennes to attack him; but they answered, they would wait for his attack. As he would not commence the combat, the enemy shot at him, but their arrows only grazed his arm and robe. He then held up the poplar, which suddenly shot up to a colossal size, was thrown, by a violent storm which arose, among the enemies, crushed many of them, and obliged the Cheyennes to retreat across the Missouri."
-South Dakota historical collections, Volume 4 By South Dakota State Historical Society, South Dakota. Dept. of History, page 569
2. Created chronologically first, but not as ancestors to all mankind. Other people came to be via separate, special creations. Quote: "The cattle were sent back to the east, where Lone Man also created white people. Lone Man created more humans, who grew and flourished. The first people he created were the Mandan." - link.
This is the Mandan nation's story of how they came from their subterranean world beneath the Earth via a vine (ala Jack and the Beanstalk) where they had lived for a very long period of time. It is their origin on the surface and the start of their history along the Missouri River. They have had this national tradition told orally for their entire known history. Further, along with their momentous origins, they get into quick conflict with the Cheyennes - who they manage to defeat by way of a miraculous poplar - another national tradition.
As Rabbi Gottlieb says, "Any national miracle that would create a national tradition is unforgettable. So, if a nation believes in such a miracle, we have sufficient reason to accept that belief as true." -link
Or do we?
Sunday, February 21, 2010
Whether God had a part in it or not is not the question, since most would agree that the Talmud was composed l'shem shamayim and with God in mind. The question is whether requires supernatural intervention to explain itself. I don't believe it does. I don't know if you've studied the Talmud but it's essentially an effort to justify and further clarify the rules of the Mishna from the text of the with proof texts, allusions and the like.
Many times these proof texts work very well and are indeed impressive and clever, but that should be expected since the Mishna itself was composed with the Torah in mind. Other times though the efforts of the Amoraim (the Talmudic scholars) seem pretty strained and they have to go through several iterations of hair-splitting or "this-case-is-an-exception-because..." in order to come to some conclusion when an apparent contradiction arises. And there are also plenty of times when the Talmudic discussion ends in "Taiku" - where they can figure out no resolution.
Add in the fact that the Talmud itself occasionally cites natural "facts" that are now known to be false to make arguments or simply as side discussion, complements the conclusion that it is a great but still an eminently human work.
If you're looking for another vast and complex system of laws, I'd refer you to the United States' tax code. For comparison, the Talmud is written formally on less than 6000 pages, while the tax code is now more than
Tuesday, September 29, 2009
By JULIE CONNELLY
EARLY this year, Barbara Plumb, a freelance editor and writer in New York who is on Medicare, received a disturbing letter. Her gynecologist informed her that she was opting out of Medicare. When Ms. Plumb asked her primary-care doctor to recommend another gynecologist who took Medicare, the doctor responded that she didn’t know any — and that if Ms. Plumb found one she liked, could she call and tell her the name?
Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle.
Of the 93 internists affiliated with New York-Presbyterian Hospital, for example, only 37 accept Medicare, according to the hospital’s Web site.
Two trends are converging: there is a shortage of internists nationally — the American College of Physicians, the organization for internists, estimates that by 2025 there will be 35,000 to 45,000 fewer than the population needs — and internists are increasingly unwilling to accept new Medicare patients.
In a June 2008 report, the Medicare Payment Advisory Commission, an independent federal panel that advises Congress on Medicare, said that 29 percent of the Medicare beneficiaries it surveyed who were looking for a primary care doctor had a problem finding one to treat them, up from 24 percent the year before. And a 2008 survey by the Texas Medical Association found that while 58 percent of the state’s doctors took new Medicare patients, only 38 percent of primary care doctors did.
29 percent of Medicare recipients can't find a physician who is willing to take them as patients. That's huge. How high would that number go if most of the country became Medicare or Medicare-like recipients? How high will this number go if the federal government's scheduled 21% cut in Medicare payments to physicans comes real (on January 1st, 2010)?
Yeah, give everyone free coverage, but don't be surprised when you can't find anyone willing to accept it.
Sunday, September 06, 2009
Since we are moving toward socialism with ObamaCare, the time has come to do the same with other professions—especially lawyers. Physician committees can decide whether lawyers are necessary in any given situation.
At a town-hall meeting in Portsmouth, N.H., last month, our uninformed lawyer in chief suggested that we physicians would rather chop off a foot than manage diabetes since we would make more money doing surgery. Then President Obama compounded his attack by claiming a doctor's reimbursement is between "$30,000" and "$50,000" for such amputations! (Actually, such surgery costs only about $1,500.)
Physicians have never been so insulted. Because of these affronts, I will gladly volunteer for the important duty of controlling and regulating lawyers. Since most of what lawyers do is repetitive boilerplate or pushing paper, physicians would have no problem dictating what is appropriate for attorneys. We physicians know much more about legal practice than lawyers do about medicine.
Following are highlights of a proposed bill authorizing the dismantling of the current framework of law practice and instituting socialized legal care:
• Contingency fees will be discouraged, and eventually outlawed, over a five-year period. This will put legal rewards back into the pockets of the deserving—the public and the aggrieved parties. Slick lawyers taking their "cut" smacks of a bookie operation. Attorneys will be permitted to keep up to 3% in contingency cases, the remainder going into a pool for poor people.
• Legal "DRGs." Each potential legal situation will be assigned a relative value, and charges limited to this amount. Program participation and acceptance of this amount is mandatory, regardless of the number of hours spent on the matter. Government schedules of flat fees for each service, analogous to medicine's Diagnosis Related Groups (DRGs), will be issued. For example, any divorce will have a set fee of, say, $1,000, regardless of its simplicity or complexity. This will eliminate shady hourly billing. Niggling fees such as $2 per page photocopied or faxed would disappear. Who else nickels-and-dimes you while at the same time charging hundreds of dollars per hour? I'm surprised lawyers don't tack shipping and handling onto their bills.
• Legal "death panels." Over 75? You will not be entitled to legal care for any matter. Why waste money on those who are only going to die soon? We can decrease utilization, save money and unclog the courts simultaneously. Grandma, you're on your own.
• Ration legal care. One may need to wait months to consult an attorney. Despite a perceived legal need, physician review panels or government bureaucrats may deem advice unnecessary. Possibly one may not get representation before court dates or deadlines. But that' s tough: What do you want for "free"?
• Physician controlled legal review. This is potentially the most exciting reform, with doctors leading committees for determining the necessity of all legal procedures and the fairness of attorney fees. What a wonderful way for doctors to get even with the sharks attempting to eviscerate the practice of medicine.
• Discourage/eliminate specialization. Legal specialists with extra training and experience charge more money, contributing to increased costs of legal care, making it unaffordable for many. This reform will guarantee a selection of mediocre, unmotivated attorneys but should help slow rising legal costs. Big shot under indictment? Classified National Archives documents down your pants? Sitting president defending against impeachment? Have FBI agents found $90,000 in your freezer? Too bad. Under reform you too may have to go to the government legal shop for advice.
• Electronic legal records. We should enter the digital age and computerize and centralize legal records nationwide. All files must be in a standard, preferably inconvenient, format and must be available to government agencies. A single database of judgments, court records, client files, etc. will decrease legal expenses. Anyone with Internet access will be able to search the database, eliminating unjustifiable fees charged by law firms for supposedly proprietary information, while fostering transparency. It will enable consumers to dump their clunker attorneys and transfer records easily.
• Ban legal advertisements. Catchy phone numbers such as 1-800-LAWYERS would be seized by the government and repurposed for reporting unscrupulous attorneys.
• New government oversight. Government overhead to manage the legal system will include a cabinet secretary, commissioners, ombudsmen, auditors, assistants, czars and departments.
• Collect data about the supply of and demand for attorneys.Create a commission to study the diversity and geographic distribution of attorneys, with power to stipulate and enforce corrective actions to right imbalances. The more bureaucracy the better. One can never have too many eyes watching these sleazy sneaks.
• Lawyer Reduction Act (H.R. -3200). A self-explanatory bill that not only decreases the number of law students, but also arbitrarily removes 3,200 attorneys from practice each year. Textbook addition by subtraction.
Enthusiastically embracing the above legal changes can serve as a "teachable moment" and will go a long way toward giving the lawyers who run Congress a taste of their own medicine.
Dr. Rafal is a radiologist in New York City.
Wednesday, September 02, 2009
Common human prosperity and wellbeing are the goals of ethics and true, objective ethical rules are those that lead to their apex. We can analyze which ethical rules we use are closer or further away from the "true objective rules" by comparing their effects on societies on Earth, historical comparisons, logical critiques for internal consistency and the like, and reasoned discourse.
The only assumptions here are that human prosperity and wellbeing ought to be universally valued and that we have common understanding of these terms to build a consensus of action. These are not really much of leaps, especially as compared to the deontological set of rules assumed wholesale to be objectively correct by various moral Absolutists. And this way of thinking escapes the sinkhole of moral relativism where moral rules are proposed and defended by nothing more than emotion and whim.
Tuesday, August 25, 2009
Joan Stephenson, PhD
A worldwide "critical shortage" of medical isotopes is expected due to the shutdown until late 2009 of a nuclear reactor in Ontario, Canada, according to Canadian authorities. The reactor, which stopped operations because of a heavy water leak, produces as much as 40% of the global supply of molybdenum 99 (99Mo), which decays to form technetium 99m (99mTc). 99mTc is currently used in approximately 80% of nuclear medicine scans.
According to Natural Resources Canada, the world's current supply of 99Mo is produced by 5 aging reactors in Belgium, Canada, France, the Netherlands, and South Africa. The shortage was expected to be exacerbated by the temporary closing of the Netherlands reactor for a month-long maintenance inspection from July 18 to August 18. Because the isotopes have a relatively short half life, they cannot be stockpiled.
Canadian authorities said they were working with medical isotope distributors and others to maximize the use of existing isotope supplies and with other international producers to increase isotope production and to coordinate shutdowns and other operations.
That's right, we use nuclear power to make medically-important isotopes. Well, not "we," as in local US plants but we rely on foreign plants to irradiate our 'topes for us. I'm not sure why we don't have our own plants churning out isotopes ourselves, but that could be related to the fact that we haven't built a new nuclear plant in America in 30+ years. There's a brain drain of nuclear expertise from this country and we'd probably have to import some European-made design if we ever started being smart with nuclear and joined the proper energy source of the 21st century.
That's right, I think nuclear power is great. Think about it: nuclear power produces virtually no greenhouse gases and can make us virtually energy independent. Two big birds down with one stone. Oh, and if you want to create jobs - how about building new plants and building a smart nuclear engineer workforce in America? Nuclear energy has a proven safety record in America - and this is with using clunking designs from 50 years ago. How much better would we be with if we built new, more efficient and safer designs that we find in places like France? This is one area where France got it right: most of the electrical energy of France is supplied by French nuclear power plants.
Worried about nuclear waste? Read up about Yucca Mountain - a location long-studied in geology as an ideal place to store radioactive waste and practically ready for operation if the politicians would only let it. Worried about transportation of radioactive waste? The US has a track record of shipping waste thousands of times and there has never been an incident or accidental release of waste. Worried about terrorists? Seriously? You can't hold back our nation's progress based on the fear of a might-happen. All nuclear facilities in America are very well guarded.
That all said, I don't think nuclear fission will be the only power source of the future. I think solar energy is an excellent source as well. Solar energy bathes America with tons of free energy on a daily basis and if we could harness even a bit of that (particularly from our little populated, but very illuminated Southwest deserts) the Sun could easily supply more energy for us than this country uses many times over. Hydroelectric power has its niche uses but it's poor for general energy supply. Wind energy seems like a goofy idea to me and likely to always be marginal since it's such an eyesore. Other ideas like geothermal are unlikely to become much since their technical maturity would come at around the same time as nuclear fusion power and fusion could be the real powerhouse for the end of the 21st century.
Nuclear power is power of the future - whether it's made right here on Earth or has to travel 93 million miles from Sol.