tag:blogger.com,1999:blog-103332472024-03-13T23:57:52.888-04:00OrthopraxOnwards to a rational observant Judaism!Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.comBlogger380125tag:blogger.com,1999:blog-10333247.post-15722605965383450352015-09-06T22:49:00.002-04:002015-09-06T22:49:32.510-04:00Global WarmingLet's just discuss global warming for a bit. The science itself is pretty well settled at this point. The earth is indeed warming and human activities are the culprit. CO2 levels in the atmosphere are higher today than they have been in likely millions of years and do act in a greenhouse fashion. The recent increase is strongly correlated with the onset of the industrial revolution and the explosion of the human population. None of this is realistically in doubt.<br />
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Although this has been generally known for decades, the global will to do anything to counteract the trend of global warming has been, basically, a dismal failure. The Kyoto protocol, so celebrated in its time (back in the 1990s), was, with all its faults, a wonder of international diplomacy. Yet there were major national polluters who never adopted it at all and others who never acted within its principles in a serious fashion. And the reason for this is obvious. In a competitive world, to ask the nations of the world to voluntarily gear down on their economic engines, is wasted breath at best. Indeed, knowing a little bit about human behavior, it should be obvious that just asking the world to try to cut down on its energy use, is a strategy of minimal efficacy.<br />
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To my mind, it kind of like asking a severe diabetic to, y'know, try to cut down on the sweets. That strategy might work on a minority of well-motivated patients, but will far and large be an abject failure. Global warming is just like many modern human diseases - they are problems stemming from human behavior. Granted, they could be fixed by simply changing people's behavior, but that just ain't going to happen. I think that continuing to harp on trying to reduce carbon emissions are well intentioned, but just are not going to cut it. The world's appetite will not slake and the CO2 will continue to rise.<br />
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So, why aren't we trying other things? There are plenty of drugs that exist which treat and control diabetes, heck there are even surgeries which may even offer a <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00075-6/abstract?cc=y=">cure</a>. Sure, most type-2 diabetes is caused by human behavior, but so what? We can treat it by intervening in other ways. Can the same be said about global warming?<br />
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Yes! The issue is not that humans are releasing too much CO2 into the atmosphere. The issue is that it stays there and causing too much warming. But there are things we can actively do which can pull CO2 out of the atmosphere and put it in safe places. This is little different from pulling sugar out of the bloodstream and putting it back into cells where it's safe. For one, a major carbon sink are the world's forests. When trees grow they grab carbon from the air and use it to grow. Granted, stopping active deforestation is the simplest and cheapest way to maintain this carbon sink, but the world could also be actively reforesting millions of acres of unused flatlands. It's so simple, but adding millions of trees to our world would be awesome for our ecology, biodiversity and would suck in billions of tons of CO2 from our atmosphere. Why is this not already being done?<br />
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Iron is an excellent fertilizer for ocean algae. With carefully selected ocean sites, we could be dropping tons of cheap iron particles which would create huge algae blooms with loads of carbon dioxide stuck within it. The algae would eventually die and then sink to the ocean floor, taking all of that carbon down with it. This literal carbon sink could keep the carbon safely out of the atmosphere for millennia. There are numerous other hypothesized <a href="https://en.wikipedia.org/wiki/Carbon_sink#Artificial_sequestration">mechanisms</a> to trap carbon out of our atmosphere. Some are higher tech and may cost more, but are still worth considering. I don't need to list all of them here. If you are truly interested, the internet is available to all for perusal.<br />
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Now, managing the carbon is just one side of the equation. The other major variable is simply the heat itself. Even if atmospheric carbon levels remained unchanged, is there something we can do that would cool the Earth? Of course! What killed the dinosaurs? Global climate change set off by a meteorite which on impact released huge amounts of dust into the atmosphere which blocked the Sun's rays and cooled the Earth. It's also been shown that the release of sulfate compounds from volcanic eruptions cause climatic cooling effects. Could this be done artificially? <a href="https://en.wikipedia.org/wiki/Solar_radiation_management">Sure</a>. There have even been more imaginative proposals to modify sunlight by placing mirrors or lenses in orbit.<br />
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The bottom line is that global warming is happening. The best solution would be to cut down on our emissions, but that just ain't gonna happen - and even if it did, it's probably <a href="http://www.scientificamerican.com/article/have-we-passed-the-point-of-no-return-on-climate-change/">too late</a>. The next best thing is to make some alternative interventions. Like in medicine, there may be side effects, but I'd rather brave those than to just allowing global warming to happen.<br />
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[Plus, keep an eye on <a href="http://www.polywellnuclearfusion.com/PolywellReactor/PolywellReactor.html">this venture</a>. It's the most reasonable engineered mechanism for fusion power that I have yet to see.]Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com7tag:blogger.com,1999:blog-10333247.post-72010446403524793472015-06-19T00:10:00.001-04:002015-06-19T00:10:44.651-04:00Matir Issurim<span style="color: #38761d;"><span style="-webkit-text-size-adjust: 100%; background-color: white; font-family: 'Exchange SSm 4r', Georgia, serif; font-size: 18px; line-height: 28px;">"Using mail-order DNA, <a href="http://www.wired.com/2015/04/diy-biotech-vegan-cheese/">they’re</a> tricking yeast cells into producing a substance that’s molecularly identical to milk. And if successful, they’ll turn this milk into cheese. Real cheese. But </span><span style="-webkit-text-size-adjust: 100%; border: 0px; box-sizing: border-box; font-family: 'Exchange SSm 4i', 'Exchange SSm 4r', Georgia, serif; font-size: 18px; line-height: 28px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">vegan</span><span style="-webkit-text-size-adjust: 100%; background-color: white; font-family: 'Exchange SSm 4r', Georgia, serif; font-size: 18px; line-height: 28px;"> cheese. Real vegan cheese. </span><span style="-webkit-text-size-adjust: 100%; background-color: white; font-family: 'Exchange SSm 4r', Georgia, serif; font-size: 18px; line-height: 28px;">That’s the name of the project: </span><a href="https://realvegancheese.org/" style="-webkit-text-size-adjust: 100%; border-bottom-color: rgb(180, 231, 248); border-bottom-style: solid; border-width: 0px 0px 3px; box-shadow: rgb(180, 231, 248) 0px -5px 0px inset; box-sizing: border-box; font-family: 'Exchange SSm 4r', Georgia, serif; font-size: 18px; line-height: 28px; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">Real Vegan Cheese</a><span style="-webkit-text-size-adjust: 100%; background-color: white; font-family: 'Exchange SSm 4r', Georgia, serif; font-size: 18px; line-height: 28px;">. These hackers want cheese that tastes like the real thing, but they don’t want it coming from an animal."</span></span><br />
<span style="color: #38761d;"><span style="-webkit-text-size-adjust: 100%; background-color: white; font-family: 'Exchange SSm 4r', Georgia, serif; font-size: 18px; line-height: 28px;"><br /></span></span><span style="color: #444444;">Interesting project and so clearly to be the food of the <a href="http://www.washingtonpost.com/blogs/wonkblog/wp/2015/05/20/meet-the-future-of-meat-a-10-lab-grown-hamburger-that-tastes-as-good-as-the-real-thing/">future</a>. Making meat and animal byproducts like milk in the lab has clear benefits in the long run in simple terms like financial costs and environmental preservation. It'll just be quicker and easier with better quality control to make this stuff in vitro than with actual animals. With advances in food science what they produce may be indistinguishable from the natural version. It also has the added benefit of limiting the cruelty to animals, which is an endemic problem in modern factory farming. In the future it will be bizarre and backwards to eat something that comes from actual, unsanitary animals.</span><br />
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<span style="color: #444444;">But besides all the above benefits, what will it do to the kosher food industry? Is it meaningful to talk about the kashrut of single cells or the byproducts of micro-organisms? If the whole world will be eating foods made from GMO bacteria or yeast - what exactly would ever <i>not</i> be kosher?</span><br />
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<span style="color: #444444;">Perhaps it is in this way that the midrash about <a href="http://www.jewishpress.com/judaism/parsha/will-pig-eventually-be-kosher/2012/04/18/0/?print">pigs one day becoming kosher</a> will actually come true.</span><br />
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<span style="color: #444444;"><br /></span>Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com0tag:blogger.com,1999:blog-10333247.post-71585716775554995472015-06-14T01:04:00.002-04:002015-06-14T01:04:44.709-04:00Shabbos in a Pepper ShakerFound this product recently. Interesting idea, but it also emphasizes one of the greatest incidental benefits from shabbos observance in modern times.<div>
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Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com0tag:blogger.com,1999:blog-10333247.post-30229369734154853012015-06-05T08:59:00.000-04:002015-06-05T08:59:25.482-04:00Is Belief a Jewish Notion?<div class="p-block a-ok" style="-webkit-text-size-adjust: 100%; font-family: Georgia, serif; font-size: 16px; line-height: 22.399999618530273px; margin-left: 16px; margin-right: 16px;">
<span style="color: #274e13;">Gary Gutting: You say you’re a naturalist and deny that there are any supernatural beings, yet you’re a practicing Jew and deny that you’re an atheist. What’s going on here? What’s a God that’s not a supernatural being?</span></div>
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<span style="color: #274e13;">Howard Wettstein: Let’s begin with a distinction between participation in a practice and the activity of theorizing, philosophically and otherwise, about the practice. Even an advanced and creative mathematician need not have views about, say, the metaphysical status of numbers. Richard Feynman, the great physicist, is rumored to have said that he lived among the numbers, that he was intimate with them. However, he had no views about their metaphysical status; he was highly skeptical about philosophers’ inquiries into such things. He had trouble, or so I imagine, understanding what was at stake in the question of whether the concept of existence had application to such abstractions. Feynman had no worries about whether he was really thinking about numbers. But “existence” was another thing.</span></div>
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<span style="color: #274e13;">It is this distinction between participation and theorizing that seems to me relevant to religious life.</span></div>
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<a href="http://opinionator.blogs.nytimes.com/2014/03/30/is-belief-a-jewish-notion/?_r=0#more-152641">Link to complete interview</a></div>
Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com0tag:blogger.com,1999:blog-10333247.post-7914454553268523902015-05-31T02:00:00.000-04:002015-05-31T02:00:58.915-04:00Philosopher of the Week<br />
This is my favorite modern Jewish philosopher this week: <a href="http://rcpr.rutgers.edu/postdoctoral-fellows/2-uncategorised/28-sam-lebens">Samuel Lebens</a>. I came across his work actually by accident just recently, but what I've seen so far appears intriguing. [It doesn't hurt that he kind of looks like Ted Mosby and has a great English accent.] I thought it was worth sharing, especially given the paucity of jblog material lately. <br />
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He also has separate paper which I found rather interesting about the <a href="http://www.academia.edu/3693535/Early_draft_Epistemology_of_Religiosity">epistemology of religious experience</a>, which I quote below:<br />
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<em><span style="color: #990000;"><span style="font-family: inherit;">"<span class="a" style="left: 545px; top: 2001px; word-spacing: 2px;">My intention in belittling the role of belief isn't to adopt the fashionable desire to replace Orthodox </span><span class="a" style="left: 545px; top: 2119px; word-spacing: 26px;">Judaism with orthopraxy. [...]</span><span class="a" style="left: 545px; top: 2236px; word-spacing: 26px;">I claim that that epistemology places very little </span><span class="a" style="left: 545px; top: 2353px; word-spacing: 21px;">emphasis on classical propositional belief and is generally much more interested in attitudes, </span><span class="a" style="left: 545px; top: 2470px; word-spacing: 18px;">postures, make-belief, and non-propositional knowledge. Orthodox Judaism, indeed religion, so </span><span class="a" style="left: 545px; top: 2587px; word-spacing: -1px;">conceived is at once more demanding</span><span class="a" style="left: 1831px; top: 2589px;"> – </span><span class="a" style="left: 1911px; top: 2587px; word-spacing: -1px;">because it asks for much more than mere belief and practice</span><span class="a" style="left: 526px; top: 2706px;"> – </span><span class="a" style="left: 612px; top: 2703px; word-spacing: 6px;">and more human</span><span class="a" style="left: 1218px; top: 2706px;"> –</span><span class="a" style="left: 1304px; top: 2703px; word-spacing: 5px;">in that it embraces attitudes and emotions that more autistic conceptions of </span><span class="a" style="left: 545px; top: 2821px; word-spacing: 2px;">religion ignore."</span></span></span></em></div>
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<span style="color: black; font-family: inherit;"><span class="a" style="left: 545px; top: 2821px; word-spacing: 2px;">The paper is worth reading in full and I linked to it above. It gives a rather different perspective on traditional Jewish belief and behaviors and how propositional beliefs, though he surely considers them critical, are hardly the focus and are in fact among the weakest points of contact for those invested in religious life. He argues that "make-believing" that certain ideas are true is important than merely holding certain propositions to be factual. Worth a read, check it out.</span></span></div>
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<span style="color: black; font-family: inherit;"><span class="a" style="left: 545px; top: 2821px; word-spacing: 2px;">I'm going to read more of his <a href="http://nb-rutgers.academia.edu/SamLebens">material</a> when I have some time.</span></span></div>
Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com1tag:blogger.com,1999:blog-10333247.post-42357358159392102542015-05-27T19:40:00.002-04:002015-05-27T19:40:30.571-04:00Where is Everybody?<span style="-webkit-text-size-adjust: auto; font-family: UICTFontTextStyleBody; font-size: 17px;">Where is everybody? I know I've been out of the loop for awhile, but I was just checking out how things were going recently in the old jblogosphere and it seems like all of the old skeptic blogs have gone silent or have closed. Basically all my links to other blogs from this site go to places where the blog no longer exists or hasn't had a recent post in years. Why?</span><br />
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Did all the angst, confusion and cognitive dissonance that had been brewing from the crash of modernity and orthodoxy just dry up? Are all the issues resolved and have those old bloggers simply lost interest? Was the community held together by a couple of heavy bloggers like Mis-nagid or Godol Hador and once they moved on the other people left as well? Or did the party move elsewhere and nobody left directions?</div>
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I get it that hashing and rehashing issues is unfulfilling and ultimately boring, but was there no curious young people around to keep the conversation fresh? Or not enough of those who were willing to delve deeper into these issues to come out with something more productive on the other end? Maybe those deeper delvers went and became the founders of sites like <a href="http://thetorah.com/">theTorah.com</a> (a very good site by the way, which I recommend), with a much more professional appearance compared to the casual coffee shop-like venue of a personal blog.</div>
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I thought that a few years ago the "Orthoprax" were getting all this attention from rabbinic articles and published papers. Not good attention, mind you, but attention nonetheless. Presumably, the goals of those articles were to quash orthoprax sentiments among the ranks - and if so, perhaps the quiet out there is evidence of their apparent success.</div>
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As for me, my time of relative blog silence coincided with much novel busyness in my personal life. This did not leave much time for metaphysical introspection, much less for an involved blogging hobby. But that's just me - where did everybody else go?<br />
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Come back.</div>
Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com14tag:blogger.com,1999:blog-10333247.post-72982653585777411502014-02-21T13:03:00.004-05:002014-02-21T13:06:08.210-05:00The Moral LandscapeI've just finished reading <a href="http://www.samharris.org/the-moral-landscape">The Moral Landscape</a> by Sam Harris. I had been hoping to read it much earlier, like in 2010 when it was published, and when I was actively involved in the Jblogosphere discussing critical topics including the legitimacy of objective morality. But real life has a way of interrupting these extracurricular activities.<br />
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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.<br />
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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.<br />
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Here's Harris giving the general argument in a TED talk:<br />
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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 <a href="http://acherhakoton.blogspot.com/2009/05/morality-whats-hangup.html?m=1">blogger </a>post from 2009:<br />
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<i><span style="background-color: white; color: #bf9000;"><span style="font-family: 'Trebuchet MS', Trebuchet, Verdana, sans-serif; font-size: 14px; line-height: 20.15999984741211px; text-align: justify;">"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.</span><br style="font-family: 'Trebuchet MS', Trebuchet, Verdana, sans-serif; font-size: 14px; line-height: 20.15999984741211px; text-align: justify;" /><br style="font-family: 'Trebuchet MS', Trebuchet, Verdana, sans-serif; font-size: 14px; line-height: 20.15999984741211px; text-align: justify;" /><span style="font-family: 'Trebuchet MS', Trebuchet, Verdana, sans-serif; font-size: 14px; line-height: 20.15999984741211px; text-align: justify;">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."</span></span></i><br />
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Of course different people can converge on similar ideas, but it makes you wonder if Harris was a Jblog fan himself...<br />
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<br />Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com29tag:blogger.com,1999:blog-10333247.post-70424306673818527562010-06-09T14:12:00.004-04:002010-06-10T18:19:14.918-04:00Paul Davies' God<span style="COLOR: rgb(51,0,153)">"[A] deistic god, a sort of god of the physicist, a god of somebody like Paul Davies, who devised the laws of physics, god the mathematician, god who put together the cosmos in the first place and then sat back and watched everything happen…one could make a reasonably respectable case for that."</span> - <a href="http://www.youtube.com/watch?v=DxD-HPMpTto">Richard Dawkins</a> (@3:25)<br /><br /><br /><a href="http://books.google.com/books?id=C7g2WSzd6IcC&pg=PP6&source=gbs_selected_pages&cad=0_1&sig=ACfU3U04WvlBD6CqguLrPH8emIYbWsuPNw#PPA10,M1">What Happened Before the Big Bang?</a> <p></p><p class="MsoNormal">By Paul Davies </p><p class="MsoNormal">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.</p><p class="MsoNormal">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?</p><p class="MsoNormal">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.</p><p class="MsoNormal">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?</p><p class="MsoNormal">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?</p><p class="MsoNormal">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.</p><p class="MsoNormal">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.</p><p class="MsoNormal">People often ask, What happened before the Big Bang? The answer is, Nothing.</p><p class="MsoNormal">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."</p><p class="MsoNormal">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.</p><p class="MsoNormal">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.</p><p class="MsoNormal">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?</p><p class="MsoNormal">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. </p>Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com38tag:blogger.com,1999:blog-10333247.post-55826925834745807522010-03-21T12:19:00.007-04:002010-03-21T13:26:12.940-04:00The Mandan"The Mandans said that there were four stories under the earth and four stories above; before the flood they lived in a village under the earth near a lake, and a <span class="gstxt_hlt">grape-vine </span>grew down through, letting the light into the underworld. They wanted to come up and sent the mouse, badger, a strange, mythical animal and a deer to dig out a hole. Then they climbed out by the grapevine till half were on earth and a very corpulent woman broke the <span class="gstxt_hlt">vine. </span>A flood came when they were first coming out and the first tribe (Tattooed Faces) perished almost wholly. All this happened near a lake to the east. If they are good the Mandans go back to this old village under ground when they <span class="gstxt_hlt">die. </span><span class="gtxt_body"> They now found themselves on the surface of the earth. The people were led by a chief and they kept walking till they reached the Missouri at the mouth of the White River. They ascended it to the Moreau, here they found enemies in the Cheyenne, and they went to war and killed and scalped for the first time. <span style="font-style: italic; font-weight: bold;">The great chief who led them out of the earth</span><sup>1</sup> together with his sister and brother taught them to make shields, and then he divided them into bands and led them against the Cheyenne. After a long struggle he performed a miracle by which the enemy were nearly all slain.</span>"<br />-<a href="http://books.google.com/books?id=fxITAAAAYAAJ&printsec=frontcover&source=gbs_v2_summary_r&cad=0#v=onepage&q=&f=false">The Mandans: a study of their culture, archaeology and language, Volume 3<o:p></o:p></a> <span style=";font-family:";font-size:12pt;" ><span style=""> </span>By George Francis Will, Herbert Joseph Spinden</span>, page 140<br /><span style="color: rgb(0, 0, 0);"><br />....<br /><br />"The Mandans (people of the pheasants) were the first people created in the world</span><sup style="color: rgb(0, 0, 0);">2</sup><span style="color: rgb(0, 0, 0);">, 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.'"</span><span style="color: rgb(0, 0, 0);"> -</span><br />-< --><a href="http://books.google.com/books?id=m3c5AAAAIAAJ&printsec=frontcover&source=gbs_v2_summary_r&cad=0#v=onepage&q=&f=false">South Dakota historical collections, Volume 4</a><o:p></o:p> <span style=";font-family:";font-size:12pt;" ><span style=""> </span><span style="font-size:100%;">By South Dakota State Historical Society, South Dakota. Dept. of History</span></span>, page 521<br /><br />....<br /><div style="color: rgb(0, 0, 0);" class="gtxt_body"> <p class="gtxt_body">"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 <span class="gstxt_hlt">vine</span>; and when exactly half their number had ascended, and a corpulent woman was half way up the <span class="gstxt_hlt">vine, </span>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 <span class="gstxt_hlt">Mandan </span>woman was scraping a hide, a <span class="gstxt_hlt">Cheyenne </span>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 <span style="font-weight: bold; font-style: italic;">their great chief, the first man who had climbed up the </span><span class="gstxt_hlt"><span style="font-weight: bold; font-style: italic;">vine</span>, </span>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.'</p> </div> <!-- Content from Google Book Search, generated at 1269188839815501 --> <p style="color: rgb(153, 0, 0);" class="gtxt_body"><span style="color: rgb(0, 0, 0);">"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." </span><br /></p><p style="color: rgb(153, 0, 0);" class="gtxt_body"><span style="color: rgb(0, 0, 0);">-</span><a style="color: rgb(0, 0, 0);" href="http://books.google.com/books?id=m3c5AAAAIAAJ&printsec=frontcover&source=gbs_v2_summary_r&cad=0#v=onepage&q=&f=false">South Dakota historical collections, Volume <span style="font-size:100%;">4<o:p></o:p></span></a><span style="color: rgb(0, 0, 0);font-size:100%;" > </span><span style=";font-family:";font-size:12pt;" ><span style="color: rgb(0, 0, 0);font-size:100%;" > By South Dakota State Historical Society, South Dakota. Dept. of History, page 569</span><br /></span></p>1. Emphasized to demonstrate that the climbing up to the surface was not something that happened "a long, long time ago" but in the understood real history and recent past of the people as the same chief who lead them out of the ground, also lead them on the surface and lead them against their enemies.<br /><br />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." - <a href="http://americanhistory.si.edu/kids/buffalo/origin.html">link</a>.<br /><br /><span style="font-family:arial;"><br />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.<br /><br /></span><span style="font-family:arial;"><span style="font-size:100%;">As Rabbi Gottlieb says,</span> <span style="font-size:100%;">"</span></span><span style=";font-family:Arial;font-size:100%;" >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." -<a href="http://www.dovidgottlieb.com/comments/Kuzari_Principle_Intro.htm">link</a><br /><br />Or do we?<br /></span>Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com72tag:blogger.com,1999:blog-10333247.post-5732598129826133352010-02-21T11:07:00.003-05:002010-02-21T11:18:52.596-05:00From the Mail Bin<span style="color: rgb(153, 51, 0); font-weight: bold;">"I've been reading your blogs and i find them quite intriguing. I agree with u regarding the many myth and fable like stories in the Bible. The part that i find more difficult is that if the Torah was not given as a Divine Revelation then how did we get such a complex and vast Talmudic system. I mean the laws in the Talmud seem so far fetched and abstract that its difficult to believe that God didnt have some part of it. I dont thing there is any other man made system of laws that is as vast and complex as the Talmud. what r your thoughts?"</span><br /><br /><br />Whether God had a part in it or not is not the question, since most would agree that the <span class="yshortcuts" id="lw_1266768428_0">Talmud</span> was composed l'shem shamayim and with God in mind. The question is whether <span style="border-bottom: 1px dashed rgb(0, 102, 204); cursor: pointer;" class="yshortcuts" id="lw_1266768428_1">Talmudic law</span> 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 <span style="border-bottom: 1px dashed rgb(0, 102, 204); cursor: pointer;" class="yshortcuts" id="lw_1266768428_2">Torah</span> with proof texts, allusions and the like.<br /><br />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.<br /><br />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.<br /><br />If you're looking for another vast and <span class="yshortcuts" id="lw_1266768428_3">complex system</span> 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 <strike>16,000</strike>, <a href="http://articles.moneycentral.msn.com/Taxes/blog/page.aspx?post=1556373">70,000</a>.Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com82tag:blogger.com,1999:blog-10333247.post-8857949275664720712009-09-29T02:57:00.002-04:002009-09-29T03:26:53.550-04:00Medicare for All = Healthcare for None<a href="http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html">Doctors Are Opting Out of Medicare</a><br /><br />By JULIE CONNELLY<br /><br /><span style="color:#000099;">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?<br />...<br />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.<br />...<br />Of the 93 internists affiliated with New York-Presbyterian Hospital, for example, only 37 accept Medicare, according to the hospital’s Web site.<br /><br />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.<br /><br />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. </span><br /><span style="color:#000099;"></span><br /><span style="color:#000099;"></span><br /><span style="color:#330033;">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)?</span><br /><span style="color:#330033;"></span><br /><span style="color:#330033;">Yeah, give everyone free coverage, but don't be surprised when you can't find anyone willing to accept it.</span>Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com26tag:blogger.com,1999:blog-10333247.post-75594742001224872562009-09-06T02:18:00.001-04:002009-09-06T02:20:18.105-04:00Just Brilliant: "A Doctor's Plan for Legal Industry Reform"<span style="color:#000099;">By </span><a href="http://online.wsj.com/search/search_center.html?KEYWORDS=RICHARD+B.+RAFAL&ARTICLESEARCHQUERY_PARSER=bylineAND"><span style="color:#000099;">RICHARD B. RAFAL</span></a><span style="color:#000099;"> </span><br /><br /><span style="color:#000099;">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. </span><br /><br /><span style="color:#000099;">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.) </span><br /><br /><span style="color:#000099;">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.<br />Following are highlights of a proposed bill authorizing the dismantling of the current framework of law practice and instituting socialized legal care:</span><br /><a name="U101466854814BD"></a><br /><span style="color:#000099;">• 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.<br /></span><br /><span style="color:#000099;">• 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. </span><br /><a name="U10146685481UQG"></a><br /><span style="color:#000099;">• 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.</span><br /><a name="U10146685481SEE"></a><br /><span style="color:#000099;">• 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"?</span><br /><br /><span style="color:#000099;">• 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. </span><br /><br /><span style="color:#000099;">• 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.</span><a name="U10146685481KJB"></a><br /><br /><span style="color:#000099;">• 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.</span><br /><br /><span style="color:#000099;">• Ban legal advertisements. Catchy phone numbers such as 1-800-LAWYERS would be seized by the government and repurposed for reporting unscrupulous attorneys.</span><br /><a name="U10146685481KFE"></a><br /><span style="color:#000099;">• New government oversight. Government overhead to manage the legal system will include a cabinet secretary, commissioners, ombudsmen, auditors, assistants, czars and departments.<br /></span><br /><span style="color:#000099;">• 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.</span><br /><br /><span style="color:#000099;">• 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.</span><br /><br /><span style="color:#000099;">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. </span><br /><br /><span style="color:#000099;">Dr. Rafal is a radiologist in New York City.</span>Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com25tag:blogger.com,1999:blog-10333247.post-92184338231949201732009-09-02T04:52:00.003-04:002009-09-02T05:20:37.229-04:00Moral Objectivity, RevisitedExcellent post found <a href="http://humanistcontemplative.blogspot.com/2008/05/natural-objective-ethics.html">here</a> that mirrors much of my thinking on ethical objectivity, but written much more clearly and comprehensively than anything I've ever written on the subject.<br /><br />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.<br /><br />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.Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com14tag:blogger.com,1999:blog-10333247.post-28521370219321289932009-08-25T02:12:00.002-04:002009-08-25T03:19:57.827-04:00Yet Another Reason Why Nuclear Power is Good<span style="color:#000099;">Medical Isotope Shortage</span><br /><span style="color:#000099;"><br />Joan Stephenson, PhD<br /></span><a href="http://jama.ama-assn.org/cgi/content/full/302/7/732"><span style="color:#000099;">JAMA. 2009;302(7):732</span></a><span style="color:#000099;">. </span><br /><br /><span style="color:#000099;">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. </span><br /><br /><span style="color:#000099;">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. </span><br /><br /><span style="color:#000099;">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.</span><br /><br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />Nuclear power is power of the future - whether it's made right here on Earth or has to travel 93 million miles from Sol.Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com16tag:blogger.com,1999:blog-10333247.post-66570155965569232222009-08-06T01:36:00.003-04:002009-08-06T02:45:33.261-04:00The Essential OrthopraxEvery now and again Jewish skeptics of various stripes respond with some surprise when I tell them that I am observant of Jewish rituals, traditions and the like. Sure, they can understand wearing a yarmulkah for social reasons, playing along while in public and eating Thursday night chulent, but observance in private for its own sake seems like a bewildering concept. So I'd like to go over here my reasons for observance in no particular order.<br /><br />First off there's the basic essential of Jewish identity. Of course many Jews are not observant and especially not of all the minutiae of Halacha and yet still consider their self-identification as Jews to be very strong, but I find that if I'm not cognizant of the likes of Shabbos and our annual pageant of holidays then I'm missing a big part of the Jewish experience. I'm set apart from core Jewry if I don't know where the local synagogue is or what time candles are supposed to be lit. I'd feel out of sync and adrift if I'm not fasting on Tisha B'av or attending a seder for Pesach or even keeping kosher in inconvenient places. There's nothing immoral about eating meat during the nine days, but you're breaking with a shared Jewish experience if you do so. To be Jewish is to DO Jewish and identity absent these core activities may be fragile.<br /><br />And this leads into the related reason of demographics. I care about the Jewish people and our fate as a group - but demographically we are suffering deeply from the likes of assimilation and intermarriage. And who are most likely to marry out or otherwise be lost from Jewry? These are the people who are least observant. Reform Jews have an astounding intermarriage rate and low retention over generations. If Reform Judaism was the only brand of Judaism available today I would have grave doubts about the survival of Jews as an identifiable group for even just a few generations down the line. Observance is correlated with significant knowledge of Jewish texts and general heritage and is correlated with intramarriage and strong Jewish identities over generations. Commitment to an observant life is a vote of confidence in the livelihood of the Jewish people.<br /><br />Another important reason is that doing frank religious acts is a way of bringing the sacred into everyday life. Modern man is overly concerned about what he can get out of an activity. Shaking a bush and a lemon seems like a silly (and costly) thing to do without any benefit to anyone - and materially that's true. But what it does, through our history of investing in the act a sense of the divine, it brings the divine into what is otherwise a very secular existence. Now, as is well known by most who read my blog (I think), my conceptions of God are rather different from the popular views and even from what much of tradition suggests, but nevertheless, raising our minds to the transcendent of existence by using Jewish rituals as vehicles is something I consider a worthwhile effort.<br /><br />This is also related to another criticism I've heard from a friend of mind who stated that he didn't particularly believe in God because once it was understood that God wasn't a doorway for on high reward or punishment and that intercessionary prayer is ineffective then he didn't really care about the metaphysics of the matter as it doesn't really effect him either way. The philosophical abstractions I tend to conceive of don't interest him, even while he may recognize them as plausible. This is a fair criticism if you are seeking religiosity as a means to an end in the way modern man approaches virtually everything - What's in it for me? But if the goal is simply truth-seeking then it is simply that life choices follow convictions. The point is not to choose convictions for the mere sake of making your life easier. So it is from my conviction of basic philosophical positions that observant life follows.<br /><br />Now, here's a bunch of potluck ideas that are not full justifications on their own but do string through my mind: There's the sense of continuity and history with thousands year old practices. Pride in being a Jew and in being a Jew and a man in the street and at home. A sense of irony that Jews should give up their cultural and religious vocation at a unique time in history when Jews can choose whether to be Jewish or not. A sense of duty to past generations that have suffered and sacrificed on behalf of being Jewish and doing Jewish. Ethical improvement that can be accomplished through correctly applying various traditional experiences and measures. And of course for various acts there is the simple fact that I enjoy performing them.<br /><br /> So is it still so surprising why I remain Orthoprax?Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com36tag:blogger.com,1999:blog-10333247.post-16284222918420915622009-08-03T00:10:00.005-04:002009-08-03T01:52:54.140-04:00In Usufruct to the Living<span style="color:#000099;">The question Whether one generation of men has a right to bind another, seems never to have been started either on this or our side of the water...and that no such obligation can be so transmitted I think very capable of proof.--I set out on this ground, which I suppose to be self evident, <i>"that the earth belongs in <a href="http://www.merriam-webster.com/dictionary/usufruct">usufruct</a> to the living"</i>: that the dead have neither powers nor rights over it.</span> - Thomas Jefferson, 1789 [From <a href="http://press-pubs.uchicago.edu/founders/documents/v1ch2s23.html">here</a>]<br /><br />This is an interesting quote which means that one generation cannot obligate a later generation in any way. This is relevant in terms of great public debts where, by right, the time to pay it off ought to be within the same generation's lifetime which benefited from the loan. The Earth belongs to each generation fully in each's turn and a past generation cannot rightly rule over those presently living.<br /><br />As Jefferson goes on (my bolding):<br /><br /><span style="color:#000099;">To keep our ideas clear when applying them to a multitude, let us suppose a whole generation of men to be born on the same day, to attain mature age on the same day, and to die on the same day, leaving a succeeding generation in the moment of attaining their mature age all together. Let the ripe age be supposed of 21. years, and their period of life 34. years more, that being the average term given by the bills of mortality to persons who have already attained 21. years of age. Each successive generation would, in this way, come on, and go off the stage at a fixed moment, as individuals do now. Then I say the earth belongs to each of these generations, during it's course, fully, and in their own right. The 2d. generation receives it clear of the debts and incumberances of the 1st. the 3d of the 2d. and so on. For if the 1st. could charge it with a debt, then the earth would belong to the dead and not the living generation. <b>Then no generation can contract debts greater than may be paid during the course of it's own existence.</b></span><br /><br />Jefferson went even further and calculated with the given life expectancy of his time and actuarial numbers that at 21 years of age, half of the people of that generation would be dead in 18 or 19 years and therefore, "<span style="color:#000099;">19 years is the term beyond which neither the representatives of a nation, nor even the whole nation itself assembled, can validly extend a debt.</span>" As a half-life, extending a repayment of a debt any longer than that would impinge on a following generation which never agreed to accept the debt in the first place.<br /><br />In an egregious example: <span style="color:#000099;">"Suppose Louis XV. and his contemporary generation had said to the money-lenders of Genoa, give us money that we may eat, drink, and be merry in our day; and on condition you will demand no interest till the end of 19. years you shall then for ever after receive an annual interest of 125/8 per cent. The money is lent on these conditions, is divided among the living, eaten, drank, and squandered. Would the present generation be obliged to apply the produce of the earth and of their labour to replace their dissipations? Not at all."</span><br /><br /><span style="color:#000099;">I suppose that the recieved opinion, that the public debts of one generation devolve on the next, has been suggested by our seeing habitually in private life that he who succeeds to lands is required to pay the debts of his ancestor or testator: without considering that this requisition is municipal only, not moral; flowing from the will of the society...but that between society and society, or generation and generation, there is no municipal obligation, no umpire but the law of nature. We seem not to have percieved that, by the law of nature, one generation is to another as one independant nation to another.</span><br /><br />Consider this idea as our nation's federal government's uncontrolled spending of recent years has left us with a huge $11 trillion deficit with annual interest payments that amount to nearly 10% of our whole federal budget. Is it our generation alone who will be paying this debt?<br /><br />Are we doing right by our children?Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com5tag:blogger.com,1999:blog-10333247.post-75914007309221329002009-07-29T19:53:00.003-04:002009-07-29T20:14:36.800-04:00Insensible LossesI weigh about 190 pounds. That's equal to about 85 kilograms.<br /><br />To figure out the appropriate hourly fluid replenishment for a (basically) healthy 85 kg patient just lounging around in the hospital we follow the 4-2-1 rule, which is that for the first 10 kg we supply 4 cc per kg per hour, the next 10 is 2 cc per kg per hour and then 1 cc per kg per hour for the rest of the weight. So 40 + 20 + 65 = 125 cc per hour.<br /><br />This means that a basically healthy 85 kg guy (like me) loses around 125 mL of fluid from urine and insensible losses (think sweating, respiration, etc) per hour.<br /><br />Over a 25 hour period that amounts to a nice figure of 3,125 mL or 3.125 Liters. Think about it - that's a huge water debt. A big bottle of soda is only 2 Liters of fluid.<br /><br />People don't drink enough before a fast and it's dehydration far more than hunger that makes them feel like crap.<br /><br />So drink well and have a meaningful fast.Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com11tag:blogger.com,1999:blog-10333247.post-28465656441194054552009-07-28T22:21:00.004-04:002009-07-29T22:01:01.580-04:00Healthcare, Oh BoySo I was asked recently to publish my views on the ongoing healthcare debate facing this country. I’m not sure why my views are so sought out given that I have some obvious vested interests in the issue, but regardless it is a topic of interest to me and I haven’t blogged in awhile so this is a good topic to rebreak the ice on.<br /><br />To be clear, the issue at hand is the concept of a broad-covering government sponsored ‘insurance’ plan essentially modeled after similar programs like Medicaid for the poor and Medicare for the elderly to include anyone else who doesn’t fit into either of those titles. And apparently there are a whole bunch of Americans who are set in just that fix – 47 million is the number which gets thrown around, but just who are these 47 million Americans?<br /><br />From the <a href="http://www.census.gov/prod/2008pubs/p60-235.pdf">US Census Bureau</a>:<br /><br />Did you know that nearly 18 million of them are people from households that make more than $50,000 a year, i.e. people who could afford insurance but opt otherwise? And 8 million or so are between the ages of 18 and 24?<br />Did you know that around 10 million of these uninsured are not citizens of the United States, i.e. those who would not be covered by any of the public options being bandied around Congress anyway (and even should they be covered)?<br />Did you know that about 25% of these uninsured are <a href="http://www.healthaffairs.org/RWJ/Dubay2.pdf">estimated</a> to already be eligible for existing public programs?<br /><br />Now these figures likely overlap a bit, but you can pretty easily see that 47 million problems have been cut in at least half, if not more. Do ~20+ million truly uninsurable American citizens require an entire reformation of the system or are there some obvious and simple tweaks we could make that would absorb them into what already exists? Could we do that without costing (likely far more than) a trillion dollars over ten years? Hmm...<br /><br />It has also been suggested by ‘objective’ assessments of medical care provided by different countries that the United States offers healthcare at about as good quality as Iran, or something to that effect. By counting things like average life expectancy and infant mortality and comparing them to some European nations, it appears that the US comes far inferior. But what these same comparisons fail to realize is that it’s isn’t just healthcare that determines those figures. Americans tend to also be generally more unhealthy in their simple daily diets and activities than those other countries – this alone could leave the statistics showing a reduced life expectancy in America. And unlike in Europe, Americans are far less likely to abort imperfect fetuses and far more willing to try and save premature babies – thereby leading to higher reports of infant mortality.<br /><br />Additionally, US News and World Reports <a href="http://health.usnews.com/usnews/health/articles/060924/2healy.htm">writes</a> <span style="color:#000066;">“[I]t's shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates.”</span><br /><br />Now, putting that all aside for now, I’d like to discuss a couple of philosophical problems I have with the idea of these semi-socializing welfare programs in general. The key thing to always keep in mind with welfare programs is that they sound nice and kind, but there ain’t no such thing as a free lunch. See, it’s a great political ploy that works again and again and again whenever it’s tried since not only do politicians get to play the moral high ground by offering the people free healthcare, for example, (as they oppose the opposition which clearly prefers that people die without treatment) – they also get to offer them free stuff! And what electorate can resist the idea of free stuff with the moral superiority package? But it ain’t free – somebody has to foot the bill.<br /><br />Historically, those who were mandated to pay for the peoples’ insurance were the general taxpayers as they funded Medicaid, Medicare, SCHIP and so on – all unrestrained entitlements that are bankrupting this country. But also corporations and small businesses had to supply their workers with expensive health benefits which was a cost passed simply onto the consumers (ie the American people) and made American products completely uncompetitive on the international markets (which is also part of the reason why the United States is no longer an industrialized nation). And who has recently been suggested to pay for this newest gift to the American people? The middle class, of course. But how smart do you think it is to continue taxing the most productive segments of society – in a recession no less! - to sink money into the least productive? At a certain point, those smart people are going to realize that their hard work and ability is no longer working for them, but against them as they sooner and sooner hit marginal returns on their EARNED rewards. Better for them to work 30 hours a week and keep $150,000 than to work 60 hours a week and take home $200,000, eh? From where then are any of these programs going to be funded? Thus you should be not shocked at all to find that European per capita GDPs tend to be 25% less than America’s.<br /><br />And despite what people clamor on and on about, healthcare is NOT a right. You cannot have a right to a service that someone else provides. Rights are natural things that surround the idea of personal freedom which others ought not interfere with. You have the right to life, liberty and the pursuit if happiness, but you don’t have the right to impose your will on a medical professional to treat you since that would enslave him and take away his rights. Free people trade value for value and you have the right to pursue professional care of your health through peaceful interactions. Doctors are not serfs and will not put up for long being government property.<br /><br />Now, with even all of that said, the key thing to recognize is that financially the US healthcare system sucks. The U.S. healthcare system costs double what other countries cost with largely comparable end results. Even though nations with socialized medicine have a degree of rationing – so do we, TODAY. Sure, it’s not the government largely doing the rationing (though it obviously is in part as any Medicare recipient is well aware) but is it better when private insurance companies do not cover everything or have restrictively high premiums? In America we don’t ration by first come first serve, we ration by ability to pay. Better? And even though we don’t have a well organized socialized system, we still mandate that anyone coming in to an ER will be seen and treated – which is essentially the way the government eventually picks up the tab for the uninsured. The uninsured have no provisions for regular visits and simple meds to keep them in health so they show up to the Emergency Room when disaster eventually strikes, costing the system way more than regular upkeep would. So we effectively already have socialized medicine in America, we’re just paying for it ass-backwards.<br /><br />The solution? I favor the gradual removal of all of these government-sponsored entitlement programs and a return to individual payment for medical care. Way better than any fraud-infested bloated bureaucracy or even any profit-driven corporation, the best person to take care of your own expenses is you. If you’re paying, little doubt you’d pay attention to the reasons for every proposed test, little doubt you’d seek the generic drug when you’re told it works as well as the more expensive new one, little doubt you’d not want to overload the system with minor complaints, little doubt you’d take a measure of responsibility for your own care and know your own history so that your doctor at the new hospital doesn’t need to redo a whole slew of the same tests you got at the hospital in your old town. This reality plus a healthy charity mentality in medicine is the way to go. Healthcare should be recognized as a charity of high regard – millionaires should endow hospitals and individuals can help others in their community. Doctors too should be willing to take a certain number of pro bono cases, since after all, they can afford it now that they are actually receiving the money they billed from their regular patients.<br /><br />But since this is never going to happen, is a broad covering government insurance option the worst idea? Perhaps not. If creating it removes our other non-afforded entitlement programs then it may be well worth it. But will it end up being the same kind of bloated bureaucracy, with waste and fraud being hallmarks of government involvement - most probably. My prediction: it will happen eventually - it will cost a ton of money, be moderately effective and significantly rationed which will lead to the existence of a two-tiered medical coverage system. People who have private coverage will want to stay private while everyone else will be grouped in the new program. It won’t change medical care all that much but will possibly lead to simpler medical billing for many Americans. Economically we'll get by but with people far less willing to share their earnings charitably (like it is in Europe, charity is a rare gift) and our grandchildren will be the ones still paying the interest on our out of control spending today.<br /><br />Better?Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com25tag:blogger.com,1999:blog-10333247.post-41178816913036387312009-05-25T20:05:00.002-04:002009-05-25T22:01:48.066-04:00Memorial Day<span style="color:#000000;">On report about the land of America:</span><br /><span style="color:#000099;"></span><br /><span style="color:#000099;">"Jews, there, are treated just like human beings, instead of dogs. They can work at any business they please; they can sell brand new goods if they want to; they can keep drug-stores; they can practice medicine among Christians; they can even shake hands with Christians if they choose; they can associate with them, just the same as one human being does with another human being; they don't have to stay shut up in one corner of the towns; they can live in any part of a town they like best; it is said they even have the privilege of buying land and houses, and owning them themselves, though I doubt that, myself; they never have had to run races naked through the public streets, against jackasses, to please the people in carnival time; there they never have been driven by the soldiers into a church every Sunday for hundreds of years to hear themselves and their religion especially and particularly cursed; at this very day, in that curious country, a Jew is allowed to vote, hold office, yea, get up on a rostrum in the public street and express his opinion of the government if the government don't suit him! Ah, it is wonderful."</span><br /><br />-Twain, Mark. "<a href="http://books.google.com/books?id=1gIRAAAAYAAJ&pg=PR1&dq=Pleasure+Excursion+to+the+Holy+Land&ei=WTQbSrerG6CIzQTq3Jn2Cw#PPR3,M1">The Innocents Abroad</a>," 1869.<br /><br /><br />It bothers me to no end how too often do people nowadays completely take for granted the amazing country we live in. It's so cliche already, but the real freedoms we have here as well as the opportunities which permit us to reach as high as we are able are gifts unprecedented in all of human history. Sure, America is not perfect and there's plenty to criticize in its history and recent events, but the ideals it stands for, as embodied in the Constitution and the Bill of Rights, are among the best and highest ever set in text.<br /><br />So it's quite proper now to take a moment and acknowledge the great sacrifices (some with the ultimate sacrifice) given by American servicemen to protect us and our way of life. May we soon see the day when no further American soldier need give so much.Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com28tag:blogger.com,1999:blog-10333247.post-52818951777142434522009-05-25T02:01:00.004-04:002009-05-25T09:55:45.408-04:00Absurd AdventismI'm not sure why but it seems that people I meet often feel comfortable to share their nutty beliefs with me. It started when I went into see this one patient who from the very beginning upon my entrance into the exam room was eyeing my yarmulkah. This happens from time to time and nothing usually comes of it. Sometimes things do, obviously, but generally the patients don't seem to care much. Anyway, that was the way this interaction seemed to be heading since nothing came of it throughout the standard history and physical that I do for every patient. But as things were wrapping up, he gave me a strange little look and asks, "You Jewish?"<br /><br />"That I am." I respond, entirely unsuspicious. For some people it's rare for them to have extended interaction with a Jew of any stripe and so they'll often ask me an innocuous question or two.<br /><br />"Ah," he says, "I thought so."<br /><br />So I answer dry as a bone, "Oh, what gave it away?"<br /><br />He laughs, tells me I'm a funny guy - and then the conversation turns weird.<br /><br />After confirming that I observe the Sabbath on Saturdays he reveals that he's a Seventh Day Adventist and asks me if I'm worried about that. Worried about observing Shabbos? Not really, I answer. He goes on to tell me that I should be because the Pope is planning on enforcing a one-day Sabbath observance and that it'll be on Sunday. Now I'm not exactly an expert on Papal policy, nor do I closely follow Vatican movements, but that didn't sound like something high on the Pope's agenda - and in any event, I didn't care much about the Pope's efforts on that issue. I tell him that the Saturday/Sunday divide has been an issue between Christians and Jews for some time now and I wasn't expecting the Pope to start religious coercion over the Sabbath in modern day.<br /><br />Not so, he responds, the day is coming soon for when we'll all have to *run to the mountains* to escape this coming religious persecution or otherwise suffer martyrdom! He directs me to read Revelations and the Book of Daniel, where he insists that this whole course of events is clearly written.<br /><br />Woah.<br /><br />That's some wacky stuff. Eschatological beliefs in general tend to approximate different forms of nuttiness, but as the beliefs become more specific and the timeline more acute it becomes only more obvious. I was willing to chalk this one up to one man's weird understanding of religion or Papal conspiracy paranoia since I had some affinity to Seventh-day Adventists, but it turns out that this is basic ideology of the original Adventist Church!<br /><br />So sayeth Wiki, "The pioneers of the church taught that the Seventh-day Sabbath will be a test, leading to the sealing of God's people during the end times. Ellen G. White interpreted Daniel 7:25, Revelation 13:15, Revelation 7, Ezekiel 20: 12, 20 and Exodus 31:13 this way. Where the subject of persecution appeared in prophecy, it was thought to be about the Sabbath commandment. Some early Adventists were jailed for working on Sunday, in violation of various local "Sunday laws" or blue laws which legislated Sundays as a day of rest. It was expected that a universal Sunday law would soon be enforced, as a sign of the end times."<br /><br />An interesting aside is that the Adventists were early critics of the Blue Laws, which were designed in the early part of the last century to protect the so-believed Christian heritage of the nation by enforcing certain aspects of Sunday. Some of the Blue Laws still persist today throughout the country, including limitations on liquor stores to not operate on Sunday mornings and the fact that the United States Postal Service does not deliver on Sunday. In this manner, the Adventists have been suspicious of government intrusion into religious life - an orientation that benefited all minority faiths in this country.<br /><br />See, it's strange how rational-appearing people can have truly way-out-there understandings of the world laying right below the surface. Though, on retrospect, that should not have been so shocking from the Adventists, given that it is a religion founded on the *<a href="http://en.wikipedia.org/wiki/Great_Disappointment">thrice-failed</a>* predictions of William Miller and Samuel Snow regarding Jesus' immanent return in 1843/1844. As a religion focused on eschatology (hence the "advent" part of Adventist), I wonder whether there is anything to be concerned about over this rapidly expanding religion.Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com23tag:blogger.com,1999:blog-10333247.post-37700968324884118412009-05-18T22:51:00.002-04:002009-05-18T22:54:26.030-04:00Dammit Jim!<p>Just saw Star Trek over the weekend. With honor, I present:</p><p> </p><p><object height="344" width="425"><param name="movie" value="http://www.youtube.com/v/pGMLCxKPMSE&hl=en&fs=1"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/v/pGMLCxKPMSE&hl=en&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object></p>Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com8tag:blogger.com,1999:blog-10333247.post-65143844807040182422009-05-16T21:27:00.004-04:002009-05-16T21:38:37.548-04:00Where's that from?<span style="color:#000099;">If anyone who has borrowed a sum of money from Jews dies before the debt has been repaid, his heir shall pay no interest on the debt for so long as he remains under age, irrespective of whom he holds his lands. If such a debt falls into the hands of the Crown, it will take nothing except the principal sum specified in the bond. </span><br /><br /><span style="color:#000099;">If a man dies owing money to Jews, his wife may have her dower and pay nothing towards the debt from it. If he leaves children that are under age, their needs may also be provided for on a scale appropriate to the size of his holding of lands. The debt is to be paid out of the residue, reserving the service due to his feudal lords. </span><br /><span style="color:#000099;"></span><br /><span style="color:#000099;">Debts owed to persons other than Jews are to be dealt with similarly.</span><br /><br /><br /><span style="color:#000000;">Nice. Guess the source.</span>Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com11tag:blogger.com,1999:blog-10333247.post-24047149419026555152009-05-14T01:25:00.002-04:002009-05-14T01:33:44.322-04:00Who Said it?<span style="color:#3333ff;"><a href="http://en.wikipedia.org/wiki/Alexander_of_Aphrodisias">Alexander of Aphrodisius</a> said that there are three causes which prevent men from discovering the exact truth: first, arrogance and vainglory; secondly, the subtlety, depth, and difficulty of any subject which is being examined; thirdly, ignorance and want of capacity to comprehend what might be comprehended. These causes are enumerated by Alexander. </span><br /><span style="color:#3333ff;"></span><br /><span style="color:#3333ff;">At the present time there is a fourth cause not mentioned by him, because it did not then prevail, namely, habit and training. We naturally like what we have been accustomed to, and are attracted towards it. This may be observed amongst villagers; though they rarely enjoy the benefit of a douche or bath, and have few enjoyments, and pass a life of privation, they dislike town life and do not desire its pleasures, preferring the inferior things to which they are accustomed, to the better things to which they are strangers; it would give them no satisfaction to live in palaces, to be clothed in silk, and to indulge in baths, ointments, and perfumes.</span><br /><br /><span style="color:#3333ff;">The same is the case with those opinions of man to which he has been accustomed from his youth; he likes them, defends them, and shuns the opposite views. This is likewise one of the causes which prevent men from finding truth, and which make them cling to their habitual opinions.</span><br /><span style="color:#3333ff;"></span><br /><span style="color:#000000;">Quote from whom? (No cheating!)</span>Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com5tag:blogger.com,1999:blog-10333247.post-2212124296494129452009-05-11T21:43:00.002-04:002009-05-11T22:22:35.861-04:00The Physicians’ Perspective: Medical Practice in 2008"Through responses provided by approximately 12,000 physicians nationwide that included more than 800,000 data points – as well as through written comments by more than 4,000 physicians – the <a href="http://www.physiciansfoundations.org/usr_doc/PF_Survey_Report.pdf">survey</a> offers a unique and valuable insight into the practices and mindsets of today’s doctors."<br /><br />Some key findings:<br /><br />Only 6% described the professional morale of their colleagues as “positive”<br />78% said medicine is either “no longer rewarding” or “less rewarding”<br />60% said they would not recommend medicine as a career to young people<br /><br /><br />Only 17% rated the financial position of their practices as “healthy and profitable”<br />82% said their practices would be “unsustainable” if proposed cuts to Medicare reimbursement are made<br />65% said Medicaid reimbursement is less than their cost of providing care<br />36% said Medicare reimbursement is less than their cost of providing care<br />33% have closed their practices to Medicaid patients<br />12% have closed their practices to Medicare patients<br /><br /><br />49% of physicians indicated they will take one or more steps in the next one to three years that will reduce or eliminate patient access to their practices:<br />11% said they plan to retire<br />13% said they will pursue a job in a non-patient care setting<br />20% said they will cut back on patients seen<br />10% said they will work part time<br />7.5% said they will work locum tenens<br />7% said they will switch to concierge practices<br /><br /><br />So folks, for those of you who're steaming forward trying to establish a Medicare-type plan for everyone in the country - where do you expect to find doctors who will be willing to accept them? More and more doctors are finding that public health "insurance" programs reimburse them less than they're laying out, thereby making such practices frankly unsustainable. In response, more and more practices are simply not accepting such insurance programs.<br /><br />Consider: these programs which are designed to help the poor gain access to care are actually making it more difficult.<br /><br />How can the state respond?<br /><br />Oh, we get fun stories like <a href="http://www.ama-assn.org/amednews/2007/07/23/gvsb0723.htm">this</a> from Illinois where the attorney general sued clinics who were simply trying to stay in business. They refused to accept more Medicaid patients because they just could not afford to continue operating at the reimbursement rates they were receiving. Yes, apparently the state thinks it has the right not only to dictate prices but also the right to force doctors to accept them. Isn't it nice to see doctors becoming government serfs? Does anyone think actions like these will encourage people to enter the healthcare arena, much less primary care?<br /><br /><br />My solutions: return free market medicine to primary care. Don't pretend that government reimbursement is full compensation for the doctor's time and effort. Care given to those who cannot pay should be understood as charity care and should be able to be deducted come tax day.Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com15tag:blogger.com,1999:blog-10333247.post-19645648562279801452009-05-10T05:40:00.003-04:002009-05-10T05:53:04.077-04:00"CAM" BS<span style="color:#000099;">Academic medicine is supposed to be different. It is supposed to exist for the purpose of applying scientific principles to medicine and thereby making new discoveries to use to treat disease, testing them in clinical trials to find out if they are effective, and then applying them systematically. Uncritically introducing therapies that are by their very nature unscientific, therapies like homeopathy, reiki, reflexology, and “energy medicine” taints the entire scientific enterprise at these institutions. Worse, offering such therapies outside the context of a clinical trial in academic medical centers gives the patina of scientific credibility to therapies that have not earned it, promoting the impression that science supports their efficacy....Medicine has finally, after over a hundred years, evolved to the point where it can actually become truly science- and evidence-based. From my perspective, the growing uncritical acceptance of CAM in academic medicine is a major threat to the continuation of that evolution. There should be no such thing as “alternative” medicine, anyway. There is medicine that is effective, as determined by science and clinical trials, and there is medicine that is not or is as yet unproven. We should not be “integrating” the latter with the former, and especially not in academia.</span><br /><span style="color:#006600;"></span><br /><span style="color:#000000;">-Dr. David Gorsky; "<a href="http://www.sciencebasedmedicine.org/?p=28">The infiltration of complementary and alternative medicine (CAM) and 'integrative medicine' into academia."</a></span><br /><br />Excellent article. Do read: <a href="http://www.sciencebasedmedicine.org/?p=28">http://www.sciencebasedmedicine.org/?p=28</a>Orthopraxhttp://www.blogger.com/profile/11649055168953784384noreply@blogger.com4