vitualis’ Medical Rants

PortableFirefox is magic

2007-04-30T08:31:00.000+10:00

I had used PortableFirefox in one of its earlier in one of its earlier incarnations and although the concept was good, there was a questions of usefulness. Firstly, many of the plugins either didn't work, or didn't work well. Secondly, there was the problem of keeping a concurrent second list of bookmarks. When everything was done, it seemed more logical to simply use the default installed browser on the work computer.

Yesterday, I revisited PortableFirefox and I am now mightily impressed with how it has progressed. Firstly, Macromedia Flash and Shockwave work completely. Most extensions to PortableFirefox works just like to the standard installation of Firefox. Even more remarkably, updates to Firefox work perfectly for PortableFirefox as well.

I normally use Google Browser Sync to for bookmark and history management and I can happily report that it works perfectly with PortableFirefox as well! For me, this is quite important as I often do research on the web at home and would save a number of links on any browsing session for later review. With Google Browser Sync, when I load up PortableFirefox in almost any location, it is as if I have my browser on my home PC - all my internet history and bookmarks are immediately and completely available.

With regards to performance, PortableFirefox is inevitably slightly slower, being installed on a USB memory key rather than on the hard disk but nevertheless, it is still surprisingly snappy.

Written college examination finally over!

2007-04-19T00:06:00.000+10:00

Last Saturday, I sat the Royal Australian College of General Practitioners (RACGP) written examination for the fellowship. Now, I have only the clinical examination in May 2007 and assuming that I pass both and gain my fellowship, I will technically be a GP.

Although I am glad that one hurdle is past, I can only say that the written examination was long and painful, and in my humble opinion, unduly so. It was in two parts; a three hour short answer paper in the morning, followed by a four hour multiple choice paper in the afternoon. One has to question whether a seven hour examination actually provides any more information than something that is shorter.

Then, there were the entirely stupid questions like the multiple choice question asking for the antibiotic of choice for Legionella pneumonia. Frankly, if one of my patients had Legionella, the local public health unit and infectious diseases department would be jumping on the patient, I would discuss with my local microbiologist first before commencing treatment, not to mention that they would probably be admitted into hospital. Insofar as the management of Legionella pneumonia in general practice, the choice of antibiotic is frankly one of the least important aspects.

Anyway, four weeks to go until the clinical examination and then FREEDOM!

Full-fee paying local university students

2007-03-03T17:23:00.000+11:00

The Sydney Morning Herald published a colourful opinion piece by Lisa Pryor on full-fee paying local students in Australian universities (1). The gist of her article was that the full-fee paying option allowed students of lesser academic ranking (and by presumption, ability) to "bribe" their way into university. Pryor states and I quote:

"The problem with full-fee paying students is they are engaged in institutionalised bribery...

The real threat to values is the triumph of money over fairness, which full-fee payers represent. What is the point of drumming into kids an ethos of egalitarianism and the fair go at school, if we are going to teach them as soon as they leave that it is okay to bend the rules so long as you can afford it?"

On this point I agree fully with Pryor. If there is such as thing as "Australian" values, then egalitarianism and meritocracy are a key part. There is an intrinsic unfairness to the fact that for those students who cannot enter a program on academic merit alone, a large sum of cash will guarantee placement.

Nevertheless, I can see the reasoning of the universities in this regard. Unless there is a significant shift in public policy with increased funding to tertiary education, external sources of funding are required. An ideological position of "pure" meritocracy would either require a contraction in positions, and/or higher tuition fees for all students.

In the example of full-fee paying international students, we do not consider that these students are "taking local places". Not only do their tuition fees fully fund their course, but they also help subsidise the remainder of the university. This "export" of tertiary education has become an important sector in Australian trade with a 123% increase in the international student population between 1997 and 2002 (compared to an 20% increase of local students) (2).

A discussion of full-fee paying university positions

Let us assume that:

There will not be any substantial change in government funding for tertiary education;
and that some form of "privatised" tertiary education in public universities is a necessity for the economic viability of the universities (insofar as maintaining current standards).

Firstly, we must ask the question as to whether "private" tertiary education positions are acceptable at all. I believe that the answer is in the affirmative. Specifically, Australians accept "private" (i.e., non-government) schools for both primary and secondary education. Many "aspirational" families indeed have a preference for these schools.

Now, given that there is no intrinsic objection to non-publicly funded education, the second question is whether private positions are acceptable within a public institution. Given the paucity of "private" tertiary educational institutions in Australia, this would seem to be a necessity. Furthermore, the fact that the highest quality and most prestigious universities in Australia are public rather than private institutions (in comparison to the United States) should be a source of national pride.

There are no obvious examples in primary or secondary education that we can draw upon, but perhaps, an analogous situation can be taken from the health system. On the whole, most people do not find it objectionable that there are patients with private health insurance in public hospitals. Indeed, there are clear benefits to the system as privately funded patients (i.e., their insurer) not only fully pays for their stay, but the small profit that the public system makes reduces the public funding load for everyone else.

Extrapolating this into the tertiary education system, I believe that there are indeed benefits in having full-fee paying students in public universities.

What are the objections to full-fee paying students?

I can see a number of specific issues problems with public universities accepting full-fee paying students:

Entry by lesser academic merit / advantageous financial merit

The first is discussed in the aforementioned opinion piece by Pryor. The current system allows economically advantaged students a "bypass" into what is essentially the same position if they do not meet the entry criteria by academic standards alone. This is perhaps particularly odious when full-fee paying students change into a HECS-HELP (3) funded position after "getting their foot in the door". Clearly this is inequitable.

The stance of the universities, however, is represented by the following University of Melbourne 2003 Senate Inquiry Submission who reject this notion (4):

"The University rejects the idea that enrolling full-fee paying students undermines the merit principle. The ‘clearly in’ score required of HECS students reflects supply and demand for a limited number of places, not merit, or any minimum ability to required to complete a course. All full-fee paying students meet minimum entry requirements, as do other students admitted on lower than the ‘clearly in’ score, such as those in equity programs. Many students admitted under the full-fee program would be eligible for a HECS place at another course within the University, and all of them would be eligible for a wide range of courses at other universities. In 2002, the academic performance of the commencing students in domestic undergraduate full-fee places exceeded that of students in HECS-liable places. Australian full-fee students were more likely to pass all their subjects, and to receive a first class honours grade. The strong academic performance of full-fee students demonstrates that the selection process in no way compromises academic standards."

Here, I reject the University of Melbourne's "rejection". Specifically, they have avoided the point. It is clearly acknowledged that entrance into an Australian university is based on supply and demand. Arguable, this is the case for most human endeavours. However, the ranking of the potential university entrants is based on academic principles while the acceptance of full-fee paying positions is not the case. I would propose that it is a matter of common sense that there would be a clear positive correlation of socioeconomic advantage for those students who accept a full-fee paying position compared to those that don't.

With regards full-fee paying students doing well in their tertiary studies, the conclusion made by the University is spurious. I could equally claim it supports the notion that the University demonstrates academic favouritism to full-fee paying students.

The submission states further:

"The best solution is not to abolish the full-fee paying places, but to end the quota system that creates the original mismatch between supply and demand. This is what the University proposed in its submission to the 2002 Nelson review. A second best solution is to extend income-contingent loans to full-fee paying undergraduates, and we support the government’s proposal to do this. The Minister has suggested that the $50,000 limit on loans under the FEES-HELP program be increased, and we strongly support an upward revision."

I agree with the "best solution" in principle. The rigid quota system and inadequate tertiary education funding is what drives universities to seeking full-fee paying students in the first place.

However, the "second best solution" as detailed above is diametrically opposed to the "best solution". Moving down that pathway is a validation of the existing system. The University is trying to walk down both sides of the street; trotting out the best (but politically unpopular) solution and killing it in the same breath with a flawed but politically acquiescent position.

Government funding into privatised positions

This issue goes to the heart of social equality. It is not only an issue in tertiary education, but also primary and secondary education as well as health. When someone has the socioeconomic advantage to be able to choose the "non-standard" option, should public money be used to support that choice?

I believe that public money should not be used in this fashion. For example, we may give social benefits to someone who is unemployed but it would be ludicrous to give that same benefit to someone who is not only employed but wealthy. Nevertheless, the incumbent conservative Federal Government seems to not agree with a progressive increase in funding of non-government schools at the expense of government schools since the mid-1990s (5).

In the context of tertiary education, we have the FEE-HELP scheme (3). States the Government policy:

"Students paying full fees for an undergraduate course do not currently have access to an income contingent loan scheme. This means that a qualified student who is offered a full fee paying place but who does not have the means to pay up front or can not take out a commercial loan can not access a place. This is inequitable."

I reject this assessment that it is (i) inequitable, and that (ii) government assistance through a deferred "income contingent loan scheme" is the correct solution. The Federal Government is moving the goal posts and forcing the public and the universities into a new status quo.

What is unstated in their "support for students" section of the policy paper is that this so called "inequity" is of the government's making, by setting rigid HECS-HELP quotas and encouraging universities in offering more "full-fee" funded positions. It seems to me that a clearly better solution is that any funding that would have been given through the "FEE-HELP" scheme to be applied to the HECS-HELP, i.e., by either reducing the cost of publicly funded university positions or by increasing the number of publicly funded positions.

I believe that students accepting a full-fee paying university position should do exactly that; be full-fee paying and to do so up front.

A proposed "fair" model that includes full-fee paying students

I believe that I have demonstrated that there is nothing fundamentally wrong with a partial privatised system but that there are many inequities to the current system. The following are a list of suggestions that I believe will make the system more fair:

1. Separate the admissions pool for private vs. public students
You can apply for any one course either through the publicly-funded system (where you are ranked and compete with other students on the "public" list) or you you can apply through the full-fee paying system (where you are ranked and compete with other students on the "private" list). That is, if you apply and are not offered a publicly funded position, you cannot "weasel" into the course by giving the university a large sum of money.

2. Relax the strict quota system that the universities are placed under
Universities may offer "x" number of places to prospective students under the quota. Naturally, there will always be a shortfall. The current system is such that the universities cannot then offer further publicly-funded positions in subsequent rounds (this is the basis the universities use to claim that their full-fee funded positions are "fair"). Clearly, it would be much fairer if the system allowed the universities to fill their publicly-funded positions with publicly-funded students!

3. Full-fee paying students must not be able to "convert" partway into publicly-funded position
I believe that when you start a university course as a full-fee paying student, you are entering into a social contract with the nation. Arguably, if someone wants to change courses, they should have access into either a publicly-funded or a full-fee paying position. However, I think that it is clearly unfair for a full-fee paying student to then subsequent enter a publicly-funded position in the same degree.

4. Full-fee paying students must be just that
It seems illogical for a full-fee paying student to receive public funding for their studies. Surely, any such funding would be better spent on more publicly-funded positions.

References

Pryor L. First lesson at university: have the cash, can jump the queue [opinion]. The Sydney Morning Herald. 3 March 2007. [Link]
Lukic T., Broadbent A., Maclachlan M. International higher education students. Strategic Analysis and Evaluation Group, Research Note No. 2, May 2004. Australian Government, Department of Education, Science and Training. [Link]
"Support for students", Our Universities: Backing Australia's Future, Policy Paper. Australian Government, Department of Education, Science and Training. Last updated: 16 November 2006. [Link]
Submission to the Employment, Workplace Relations and Education References Committee. Inquiry into Higher Education Funding and Regulatory Legislation 2003. The University of Melbourne. Submitted: 14 August 2003. [Link]
Australian Government funding to public and private schools. Australian Education Union. April 2004. [Link]

A discussion on euthanasia

2007-02-03T23:00:00.000+11:00

I have recently been participating in an Australian web forum for current and prospective Australian medical students known as "Paging Dr." The following article is mostly derived from a number of posts that I wrote on that forum.

I am gratified to see that euthanasia has come back into the social agenda, in the Sydney newspaper press in any case. On Australia Day (26 January 2007), The Sydney Morning Herald published a wonderfully human story on Dr John Ellison, a Sydney medical doctor dying from myeloma who travelled to Switzerland to "end his life with dignity"(1). He sought the assistance of a Swiss charity "Dignitas" who assist patients with suicide. About Dignitas (from the BBC)(2):

"Dignitas was founded in 1998 by Swiss lawyer, Ludwig Minelli, who runs it as a non-profit organisation.

It takes advantage of Switzerland's liberal laws on assisted suicide, which suggest that a person can only be prosecuted if they are acting out of self-interest...

...The law on suicide actually states:

"Whoever lures someone into suicide or provides assistance to commit suicide out of a self-interested motivation will, on completion of the suicide, be punished with up to five years' imprisonment".

Dignitas interprets this to mean that anyone who assists suicide altruistically cannot be punished.

Its specialist staff all work as volunteers to ensure there can be no conflict of interest..."

The reason why someone from Australia would travel to Switzerland for euthanasia, of course, is that euthanasia is illegal in Australia. There is clearly a demand for euthanasia services. Let us explore some of the issues regarding this contentious subject.

Do people have a right to death?

Firstly, consider the fundamental question, for the moment outside the boundaries of law and ethics: "do people have a right to choose the option of death?"

If the answer is in the negative, then obviously euthanasia cannot be condoned by any means.

However, I believe, that in some settings, the answer is clearly in the affirmative. It helps to consider a scenario; a captain who "falls onto a grenade" to save his men has clearly chosen to sacrifice himself for a particular (and noble) reason. In fact, he is considered heroic. I can think of any number of other scenarios but it is clear that there is no blanket ban for a person choosing to die.

Indeed, if we consider this from a civil liberties point of view, then surely if we have a right to chose the way we live, the logical conclusion is that we can chose to die given that the endpoint of life is universally death.

"In some settings"

Establishing that someone has a right to choose death, however, does not mean that as a society must accept that choice unconditionally. Death by its nature is irreversible and the tenacity for the will to live is so strong that in most settings we would consider the voluntary act to extinguish life to be contrary to the human condition. We, for example, almost always consider a victim of suicide to be a tragedy and would aim to prevent it if possible. Mosts survivors of attempted suicide retrospectively view those events of their life as extreme low points.

In what settings then would euthanasia be considered acceptable?

Let us first describe an unambiguous case. A person with terminal metastatic cancer with extreme pain who has an expected lifespan measured in hours to days. By giving a sufficiently high dose of analgesic to control symptoms, a hastened death would be likely. I think that most people would consider the ethical duty to treat the distressing symptoms to overwhelm the ethical duty to not harm the patient (indeed, what further harm can be done?)

I think it is important to recognise this case. The reason being is that this is clinical reality and it happens every day across the globe and has been the case for centuries. It is important to note at this stage that many people do not consider this to be "euthanasia" as the argument is that the aim of the active treatment is to treat symptoms rather than to hasten death. Nevertheless, I feel that this may be a case of intellectual sophistry as we are still knowingly hastening death.

The "real" public debate on euthanasia

The above scenario is not really debated except as a point of grounding. That is not the "real" debate on euthanasia. When someone is on the "cusp" of death for the most part the debate is rendered irrelevant.

The real debate is for someone like Dr John Elliot as described in the above article. I quote verbatim(1):

"It is minus 5 degrees outside in Zurich and she knots a white scarf around his neck. As he walks out the door he breathes and says faintly: "I'm free."

The taxi drives a few blocks to a snowy, suburban street. In the ground-floor flat of a plain, four-storey building they meet a male nurse and a female social worker.

They sign documents. Dr Elliott, from Rose Bay in Sydney, takes a preparation to prevent vomiting. The nurse, Arthur, mixes a drink containing the barbiturate sodium pentobarbital and water.

As they wait 30 minutes for the anti-emetic to take effect they drink a cognac and chat. Arthur says he is from Davos, in the mountains. Oh, Dr Elliott says. He and Angelika used to go to the nearby village of Clavedel. They had so many happy days there.

With a video tape rolling, for legal purposes, Arthur asks Dr Elliott whether he realises that if he takes the drink he will die. Dr Elliott says he does.

"You can opt out at any time," the nurse says, several times.

"No," says Dr Elliott, an American-born doctor who never practised in Australia.

"I just want to get going. Hurry up."

About 10.10, sitting in a chair, Angelika holding his hand, he drinks. "It's not bitter at all," he says, surprised.

He has another cognac. His wife hugs him for the last time in 34 years of marriage. He starts to look drowsy, then his head nods forward, like any person falling asleep. In 15 minutes he is dead.

Dr Elliott spent the last hour of his life as he spent his last three months, unflinchingly determined to die."

The real debate on euthanasia is someone who has a terminal illness who prefer death rather than face an expected adverse effect on their quality of life in the near future, and they are otherwise well enough such that they are at minimal risk of dying from natural causes in the short to medium term.

The criteria for allowing euthanasia

If we accept then that (i) people have a fundamental right to chose death in some settings, and (ii) there is at least one unambiguous scenario where euthanasia is considered a clinical norm, what then follows as the criteria we use to "allow" people to choose death?

1. "Personal choice and competence"
Although this is needed, it is clearly not enough. Many people with depression who attempt suicide also "choose" their actions but we rightly (i) try to prevent suicides and (ii) try to resuscitate people who have had a suicide.

So thus, we must establish that people who make this "personal choice" are competent to do so. This is not a trivial thing to do. It is essentially a contradiction to ask whether someone who wants to suicide is in the "right mind" to choose it.

An analogy: someone who is hypomanic often feels fantastic when they are unwell. If they are an intelligent hypomanic, then they can make the most convincing arguments against treatment. how it is their "choice" to remain this way. Indeed, "people with hypomania are generally perceived as being energetic, euphoric, overflowing with new ideas, and sometimes highly confident and charismatic."(3) This of course all falls down then either they are treated or the hypomania stops. When they are well, they have the insight to their illness, which is why for the most part, we still treat people with mild bipolar disorder.

Establishing whether someone is in the "right mind" to chose death is not an easy thing as the experience of suicidal thoughts are that they go away when the underlying affective disorder or social situation improves.

Thus, not only must it be the personal choice of the person, but it must be established that they are completely free from all mental illness; something that I believe to be difficult to establish in someone with a terminal malignancy.

2. Delegation of responsibility
Following on from personal choice and competence comes the question whether the responsibility of the choice can be delegated to others; for example, the family, the treating doctor, a carer/guarding, a public guardian, or even some form of advanced directive. This is highly relevant considering that many terminal illnesses may lead to a decline in cognitive function.

The answer to this is fraught with dilemma. There are practical considerations but at the same time, there are obvious inherent conflicts of interest:

family (release from burden of care, potential financial payout);
doctor/health system (release from burden of care / lower health costs);
a public guardian (the shorter the lifespan of their client, the less work they have to do).

For a person with a terminal illness, there are many stakeholders apart from the ill person who would benefit from a hastened death. Where there is a legislated pathway, there would also be a huge potential for abuse, unless, it was strictly regulated.

3. "Terminal condition"
Must there be a "terminal condition" for a patient to choose euthanasia? This is a hard question. One must consider people with multiple sclerosis, motor neurone disease and degenerative neuromuscular diseases. In themselves they are not "terminal" in the way malignancies are.

In the follow on from this question is the time frame. Too short a time frame and it would exclude just about everyone. Too long a time frame and there will be a subset of patients who may not have had a terminal illness at all.

For example, let's say that an inclusion criteria is that your expected lifespan must be less than 6 months. A small percentage of these patients may live for years if they are not euthanised ("life expectancy" is firstly a grouped average and secondly is more art than science).

Thus, if we use "presence of a terminal condition" as an inclusion criteria, it necesitates a time frame and the time frame chosen will be purely arbitrary.

4. Quality of life
Must the patient have an expected deterioration in their quality of life? The answer would appear to be "yes", but, the devil is in the details. How much reduction?

Furthermore, can this even be competently determined on an a priori basis?

For example, requiring a colostomy bag may be the worst thing that a particular person can imagine. The reality of a colostomy bag, however, may be much less onerous. On the other hand, managing a colostomy may actually be a terrible imposition on that person if they had to do it.

Thus if we accept that we must take quality of life into account, we must not only gauge whether the expected reduction is real, but also whether the person has realistic expectations. Clearly, euthanasia should not have a place as a method of treating a person's fears of the future.

5. Other problems - refusal of standand therapy
If we permit euthanasia, could a patient be included if they refuse standard therapy?

Examples:
A person has an operable colon cancer but it would involve a colectomy (i.e., colostomy bag) with chemotherapy. They refuse treatment (clearly within a persons right to choose) but wants euthanasia (so not to have to experience cancer death).

A more subtle example:
A person has metastatic melanoma (i.e., inoperable) but targeted radiotherapy and chemotherapy / immunotherapy could lead to significant improvement in both quality and quantity of life. They refuse treatment (again clearly within their right) but wants euthanasia (so not to have to experience cancer death).

The significance of these questions is that they are realistic. Most patients in fact do have options other than euthanasia; treatment modalities that would either improve their symptom control and/or improve their lifespan.

Practical implications of legalised euthanasia

The point of the above discussed criteria is to highlight that if euthanasia were permitted, it would by necessity be rigidly regulated, and that any inclusion and exclusion criteria arbitrary and at some level, inconsistent. Many people who may "benefit" from euthanasia will still not have access to it. Some people who are euthanised will on retrospectively analysis be considered to have been a bad decision.

To a certain level, clinics like Dignitas as described in the Sydney Morning Herald article work because they are a rare and limited service and their clients are highly self-selected motivated individuals.

For a widely available and accessible service (which would be the implication of "legalised" euthanasia) a lot of money will need to go into the regulatory framework. From an economic point of view, one must consider whether the manpower, intellectual investment and money would be better spent elsewhere (e.g., palliative care).

"Passive" and "active" euthanasia - consideration of ethics

"Active" euthanasia is when "the medical professionals, or another person, deliberately does something that causes the patient to die"(4).

For the most part, "active" euthanasia is illegal in both Australia and worldwide (with a few exceptions).

"Passive" euthanasia occurs when "the patient dies because the medical professionals either don't do something necessary to keep the patient alive, or when they stop doing something that is keeping the patient alive". Activities that would fit this definition is legal and in many places part of standard therapy. It is considered a practical necessity.

However, is there actually an ethical difference between the two?

Some people argue that there isn't. Giving someone a lethal cocktail to hasten death is an active process on the part of the health professional. Withdrawal of active therapy is also an active process. Even withholding therapy (e.g., not giving further blood transfusions) is at a cognitive level an active management choice.

Thus, it can be argued that given we accept withdrawal of therapy as a valid medical decision, and that there is no ethical distinction between this and so called "active euthanasia", the logical conclusion is that euthanasia should not only be legal but performed were clinically appropriate.

There is a lot of appeal to this argument but I believe that it suffers from a flaw.

"Active" euthanasia leads to death due to the intervention given by the medical practitioner.
"Passive" euthanasia leads to death due to the natural history of the disease.

If you believe that this makes a difference then it means that "passive" euthanasia cannot be lumped in the same class as "active" euthanasia.

If you don't believe that it makes a difference (i.e., planned active decision resulting in death in both cases) then it can even be argued that active euthanasia is morally superior as it results in less distress and discomfort for the patient.

I believe that it makes a difference (my personal opinion).

It is the duty of doctors to improve health and prolong life, but not prevent death by all means possible (which is impossible). Death is a part of life and part of being a doctor is to allow people to die. That is, I don't believe that there is any ethical principle against letting people die from "natural" reasons. Quotation from the 19th century poet Arthur Hugh Clough:

"Thou shalt not kill but needst not strive, officiously, to keep alive."

There is, however, the ethical principle of non-maleficence - i.e., we should refrain from something that harms a patient. Is providing active euthanasia to a patient who desires death it "harming them"? It can be argued either way.

Thus the conclusion is that "passive euthanasia" is okay but "active euthanasia" may or may not be okay on a medical ethics basis, and, that there is a distinction between the two. This is somewhat the status quo though there are strong differing points of view within bioethics.

Reference articles

Button, James. My name is Dr John Elliott and I'm about to die, with my head held high. The Sydney Morning Herald. 26 January 2007. [Link]
Dignitas: Swiss suicide helpers. BBC News. 20 January 2003. [Link]
Hypomania. Wikipedia. Accessed 4 February 2007 (last updated 23 January 2007). [Link]
Active and passive euthanasia. BBC - Religion & Ethics. Accessed 4 February 2007 (Last updated: 20 July 2006). [Link]

"The Creation of The Medicine Box" published

2006-10-08T14:28:00.000+10:00

This book, “The Creation of The Medicine Box” is a comprehensive documentation of the design, goals, development and construction of this website. It contains a review and analysis of the state of the project after six months from its launch in April 2006.

This report was in addition written and designed as a guidebook to the development of online medical education resources.

“The Medicine Box” represents a significant body of work. We hope that you find both this book and the website worthwhile.

"The Creation of The Medicine Box" has been published as a hard cover publication through Lulu.com. It can be purchased here for $US 17.95.

It can also be downloaded as a PDF ebook [4.2 MB].

“Asymmetrical” warfare – Israel’s response

2006-07-24T00:15:00.000+10:00

War crimes are not a valid response to terrorism

Israel has responded to border skirmishes and an abduction of two of its soldiers in Lebanese/Israeli border by Hezbollah militants with the unilateral declaring war on the Lebanese government and launching a devastating bombing campaign into Southern Lebanon.

In essence, it has responded to terrorism with what can only be described as flagrant war crimes.

Regardless of Israel’s claim of only targeting “Hezbollah” facilities and installations, the truth on the ground is clear. Israel has systematically targeted civilian facilities. Roads, entire neighbourhoods have been flattened by the air strikes. Over 350 Lebanese have been killed, the majority being civilians. At least a half of a million people in southern Lebanon have been displaced. Recently reported today, Israel has started targeting television and radio transmission towers within Lebanon, even those unrelated with Hezbollah.

States UN High Commissioner for Human Rights Louise Arbour:

“Indiscriminate shelling of cities constitutes a foreseeable and unacceptable targeting of civilians… Similarly, the bombardment of sites with alleged military significance, but resulting invariably in the killing of innocent civilians, is unjustifiable.”

Although Arbour did not specify individuals, she suggested that leaders could bear personal responsibility. It is universally acknowledged that the actions of Hezbollah militants toward rocket attacks on civilians constitute terrorism. The action of the Israeli military and government should be measured by the same standards. Again, Ms Arbour:

“There is an obligation on all parties to respect the principle of proportionality.”

As a point of comparison, a total of 35 Israelis have died in the recent conflicts, 15 of them civilians. That is, the Lebanese casualties are over an order of magnitude worse.

This disproportionate warfare has hardly been lost to the people of Western Europe or the United States. There have been extensive anti-war protests in London as well as significant diplomatic disquiet. Nevertheless, both the United Kingdom and United States have resisted official condemnation of the Israeli action or calls for a ceasefire. The United Kingdom, nevertheless expressed its displeasure unofficially through the comments of Mr Kim Howells, the Foreign Office minister who stated:

“I very much hope that the Americans understand what’s happening to Lebanon. The destruction of the infrastructure, the death of so many children and so many people. These have not been surgical strikes. And it’s very difficult, I think, to understand the kind of military tactics that have been used. You know, if they’re chasing Hezbollah, then go for Hezbollah. You don’t go for the entire Lebanese nation.”

British Prime Minister Tony Blair official spokesperson has supported Howells statement.

It is interesting to read the United States position on the conflict. The United States has by large given explicit consent for the Israeli military campaign and has placed the “blame” solely on Hezbollah. Lebanese civilian casualties, just like those of the Gazans have been ignored behind the glib “Israel has a right to defend itself”. Syria and Iran are the usual bogeymen with their arms support for Hezbollah. The hypocrisy is breathtaking.

Rather than condemning the Israel’s bombing strategy, the United States, Israel’s main weapons supplier, has expedited a shipment of munitions to Israel. Far from simply “looking the other way”, the United States is complicit in this slaughter of civilians.

Even more ludicrous is the suggestion by Australia’s feckless Foreign Minister Alexander Downer who claimed in the 7:30 report:

“Hezbollah should immediately withdraw from southern Lebanon and leave Israel alone, and the sooner they do that, the better.”

I can fully agree that Hezbollah should “leave Israel alone”, but our esteemed foreign minister needs to explain why the Lebanese should “withdraw” from their own country for the sake of the Israelis. Of course, parroting US foreign policy dogma seems to be the standard path for the Howard Government.

The international effort for peace must be pursued. Violence begets only violence.

Source articles
Perry T. Israel and Lebanon under fire. Reuters. 23 July 2006.

Tostevin M. Diplomatic flurry in Israel over Lebanon war. Yahoo! News (Reuters). 23 July 2006.

Long G. Thousands march in protest against Israeli attacks. Yahoo! News (Reuters). 22 July 2006.

Noueihed L. Lebanese flee north raising white flags. Yahoo! News (Reuters). 22 July 2006.

Pickler N. Bush: Rice trip will focus on Hezbollah. Yahoo! News (Associated Press). 22 July 2006.

Minister condemns Israeli action. BBC News (International). 22 July 2006.

US rushes precision-guided bombs to Israel: NYTimes. Yahoo! News (Reuters). 22 July 2006.

Israel targets Lebanese television towers. Taipei Times. 23 July 2006.

UN warning on Mid-East war crimes. BBC News (International). 20 July 2006.

Downer defends embassy staff [transcript from TV program]. ABC 7:30 Report. Broadcast 19 July 2006.

Moving to Gilgandra

2006-07-04T12:02:00.000+10:00

I am posted to the town of Gilgandra in rural NSW for the next six months for my Advanced General Practice term. As such, I am taking a short break from vitualis' Medical Rants for the next 3 weeks.

New articles will appear once internet access in the registrar house in Gilgandra has been set up.

Best regards,
Michael Tam

vitualis' Medical Rants - Volume 3 published

2006-07-02T22:40:00.000+10:00

Following tradition since this blog was revitalised in October 2004, a biannual compendium of vitualis' Medical Rants is published in print form (what Wikipedia refers to as a "blook"). Just released is Volume 3: January to June 2006 - available in soft cover, hardcover and as an ebook in Adobe PDF format.

The printed version of vitualis' Medical Rants contains the full text of the original articles, but furthermore, also contains reprints of the original reference articles as well.

I will take this opportunity to thank all my readers for their kind support.

Best regards,
Michael Tam

Mutual terrorism

2006-06-30T14:31:00.000+10:00

The Israeli-Palestinian disaster

Israel unleashed its military machine in the past few days, ignoring global calls for calm and restraint. For one captured and murdered soldier, Israel has accelerated the conflict to outright war. Launching night raids across the occupied West Bank and East Jerusalem, Israel captured and arrested the majority of the ministers and members of parliament of Hamas.

Hamas has stated that these raids were an act of “open war against the Palestinian Government and people” and it is hard to see how this is not so. States an Israeli Foreign Ministry official (Mark Regev):

“If the government of the Palestinian Authority says it’s okay to send rockets into Israel, to kidnap Israelis, to behave like terrorists, then they will be treated like terrorists.”

The hypocrisy of this statement is unfortunately lost on most people, and obviously, the Israelis. The Israeli Government has launched dozens of aerial attacks into Palestinian urban areas, killing an order of magnitude more civilians. It has routinely “kidnapped” Palestinians through its extrajudicial security sweeps.

As for behaving like “terrorists”, in the past two days, Israeli attacks targeted the Gaza Strip’s only power station and have left 700,000 Palestinians in the Gaza without power and with a threatened water supply. The Foreign Ministry has described civilian infrastructure as “legitimate targets”. Sorry Mr Regev, but targeting civilians and civilian infrastructure in such a manner is an act of state sponsored terrorism and a war crime.

As I have argued on numerous occasions the ethics and morality of action needs to be examined through the lens of “universality”. If we apply the reasoning that Israel uses to justify its attacks to Hamas, then surely Israeli “civilian infrastructure” would also be “legitimate targets”. Attacking and kidnapping of Israeli ministers and MPs would be justified.

This is obviously not the case. As such Israeli should be condemned in perpetrating this highly unethical, if not illegal military action against the Palestinian people.

In just six months since the Ariel Sharon broke away from Likud to form the centralist Kadima party, the hope that he created for a new peace between Israelis and Palestinians has faded like the man.

From: The Sydney Morning Herald

Acts of war: Middle East on edge (excerpt)
Ed O'Loughlin Herald Correspondent in Gaza and agencies
June 30, 2006

...In night raids across the occupied West Bank and East Jerusalem, Israeli troops rounded up most of the ministers and MPs representing the non-Gaza wing of the Palestinian ruling party, Hamas.

Hamas has described the raids as an act of "open war against the Palestinian Government and people" and said Israel would have to face the consequences...

...Israel's move against the Palestinian Authority in the West Bank is only the most serious of a number of grave developments threatening to escalate an already fraught situation into all-out war and humanitarian disaster...

...On Wednesday Israeli jets buzzed the summer palace of Syria's President, Bashar Assad, driving home Israel's threat to assassinate Hamas leaders at large in Gaza and in exile in Syria. Syria said its air defences fired on the aircraft without hitting them.

Early yesterday Israeli troops found the body of a murdered 18-year-old Jewish settler - Eliyahu Asheri, who is the son of an Australian immigrant - abducted by Palestinian militants in the West Bank on Sunday.

In Gaza, meanwhile, militants belonging to the mainstream Fatah military wing, the al-Aqsa Martyrs' Brigade, claim to have fired a chemical-tipped missile into Israel for the first time...

...Israel's Prime Minister, Ehud Olmert, has said that Israel will not negotiate to release Corporal Shalit and will take "extreme actions" if he is not freed.

"Our aim is not to mete out punishment but to apply pressure so the soldier will be freed," he said. "We want to create a new equation: freeing the abducted soldier in return for lessening the pressure on the Palestinians."

Over the past 48 hours, Israeli attacks - including artillery bombardments, tank incursions and the destruction of two bridges and the strip's only power station - have left 700,000 people without power and threaten to cut off water to 1.3 million Gazans.

The actions have been condemned as "collective punishment" by human rights groups and by the British Foreign Office...

Guantanamo Bay military tribunals ruled unconstitutional

2006-06-30T13:36:00.000+10:00

In a stunning blow against the Bush Administration, the US Supreme Court has ruled in a five-to-three decision that the military tribunals held in Guantanamo Bay against the detainees were illegal.

Specifically, it stated that the Geneva Conventions covering prisoners of war had to be applied to proceedings against all the prisoners.

However, the court did rule that the administration had the authority to hold the prisoners and whether they should be held as prisoners of war did not appear to be within the scope of the ruling. Of the eight prisoners held who have had charges made against them (including Australian David Hicks), this is a major breakthrough. It has already been argued that the charges brought against Hicks are invalid under the Geneva Conventions.

The position that the Guantanamo Bay detainees should be released as has received a major boost. The camp should be closed with all haste.

From: The Sydney Morning Herald

Military tribunal for Hicks illegal (excerpt)
Michael Gawenda
June 30, 2006

...The US Supreme Court has ruled that the military commissions set up by the Bush Administration to try prisoners, including David Hicks, at Guantanamo Bay are illegal and must be abandoned.

In a major blow to the Administration the five-to-three decision of the court said the Geneva Conventions covering prisoners of war had to be applied to proceedings against all prisoners at Guantanamo...

...It means that at the very least, the Pentagon will have to set up standard courts martial for prisoners, with all the protections afforded them under US law.

It is not clear what the Administration's response will be or how long it will take for it to set up military courts martial to try prisoners, such as Hicks, who have already been charged with offences that may not be valid under Geneva rules...

Culture of philanthropy

2006-06-26T13:06:00.000+10:00

Philanthropist extraordinaire

Philanthropy; be it by private individuals or corporate is an area where the United States clearly leads the world and definitely puts Australia to shame. To quote Charitable Choices, “Americans give a lot to charity”.

Though estimates vary, American individuals gave away on average about 2.2% of their income in 2005. Australians, on the other hand, gave a mean of $424 in 2005, or about 1% of earnings, or only half as much.

No more stark is the difference in the culture of philanthropy demonstrated by the corporate über-rich. The United States is known for the enormous contributions of its corporate leaders to charitable organisations. Most recently, Bill Gates of Microsoft fame, the wealthiest individual in the world, announced he was resigning from his role in his corporation so that he could focus on charitable activities through the Bill and Melinda Gates Foundation. This foundation has given billions away for the funding of health and education initiatives, in both the developing world and domestic United States. Today, Warren Buffet, the world’s second richest man announced that he planned to give away 85% of his fortune (worth $54 billion) to charities. He planned to become a trustee of the Gates Foundation.

Compare this to recently deceased media mogul Kerry Packer, wealthiest man in Australia. His contribution to public philanthropy was (relatively) small and ultimately self-serving. Donations to the ambulance service and to hospital, though welcome, were specific to his failing health.

Without high profile leadership, the “average” Australian has simply been outclassed by the generosity of the “average” American. Public American philanthropy and willingness to assist in charities is a fantastic cultural trait that Australians should emulate. We have fantastic charitable organisations in Australia who often sadly, lack the funds and manpower to accomplish their goals.

From: Sydney Morning Herald

Buffett to give $54b to charity (excerpt)
June 26, 2006 - 6:28AM

...Buffett, 75, pledged in an interview with Fortune to give away 85 per cent of his stock - worth more than $54 billion - in his Berkshire Hathaway investment firm, starting in July.

"I know what I want to do," he was quoted as saying, "and it makes sense to get going."

The shares will go to five foundations. More than 80 per cent will go to the Bill and Melinda Gates Foundation which already has a kitty of nearly $41 billion used to pay for medical research and give educational grants.

Buffett and the Gates are close friends. According to Fortune, Buffett plans to eventually become a trustee of the Gates foundation...

“All options on the table…”

2006-06-22T19:03:00.000+10:00

This seems to be a popular US spoken response to international challenges. G W Bush said it recently (April 2006) with regards to Iran’s nuclear ambitions and the same earlier in 2005 when it was suggested that the US was planning a pre-emptive strike on Iran.

It was stated earlier on the challenges of Iraq and the “axis of evil” in a joint conference with Japanese Prime Minister Koizumi in February 2002.

And again when questioned in March 2002 about The Pentagon’s call for development of low-yield nuclear weapons.

Earlier this week, in response to the announcement that North Korea has (apparently) developed an intercontinental ballistic missile capable of reaching the continental United States (Alaska), US Ambassador to Japan too repeated the infamous phrase.

The phrase is little more than a crude euphemism that is lost on no one. “We will use force if we want to”. It is childish, and something one would expect to have been left in the playground.

David Straub, the former director of the Office of Korean Affairs at the State Department, who was deeply involved in US diplomacy with North Korea, has joined the ranks of ex-military and government officers criticising the current Bush regime’s foreign policy. He states in particular:

“Of course all options are on the table. No government ever takes any option off the table, but you don’t have to talk about it all the time.”

But then again, with people like John Bolton as a senior US diplomat, no wonder international US diplomacy is falling to pieces.

From: The Sydney Morning Herald

Bush policy a failure, says diplomat (excerpt)
June 22, 2006

...In a rare public attack on the Administration by a foreign service officer, the retired head of the State Department's office of Korean affairs, David Straub, also questioned the decision-making on the issue by the Secretary of State, Condoleezza Rice.

One fundamental failure of President George Bush's approach was the tendency to raise tensions and make South Korea nervous by stating that "all options" were on the table, a phrase underscoring US intentions to use force against North Korea if necessary, he said.

"Of course all options are on the table. No government ever takes any option off the table, but you don't have to talk about it all the time," Mr Straub said.

Mr Straub also questioned why, after six-party talks reached an important but preliminary agreement on the nuclear issue last September, Dr Rice would allow release of a statement clarifying US views on issues papered over in the agreement. The US statement prompted Pyongyang to renege on the agreement...

Another defence lawyer for Saddam murdered

2006-06-22T18:08:00.000+10:00

Khamis al-Obeidi, one of the main lawyers defending Saddam Hussein was abducted and murdered earlier this week. He is the third defence lawyer murdered since the commencement of the trial.

Al-Obeidi complained in an interview with the BBC after two of his colleagues were shot (one killed) that the trial lawyers had to organise their own personal protection.

I have absolutely no faith in the show trial. Even if Saddam is found guilty of his “crimes”, there is no meaning without justice.

From: BBC News

Saddam defence lawyer shot dead (excerpt)

...Khamis al-Obeidi's body was found dumped in the capital, Baghdad, hours after he was abducted from his home.

Defence lawyers have frequently complained that they have not been given enough protection, calling the trial's fairness into question.

Two other defence lawyers were murdered last year in the early stages of the trial, which is set to end next month...

...Mr Obeidi was abducted from his home in Baghdad's northern Adhamiya district at about 0700 local time (0300 GMT) by men wearing police uniforms.

Police said Mr Obeidi's body was found with several bullet wounds near the Shia district of Sadr City...

...In a BBC interview after one of his colleagues was killed last year, Mr Obeidi strongly denounced what he called the "assassination", and complained that the trial lawyers mostly had to organise their own personal protection.

Another lawyer on Saddam's defence team, Bushra al-Khalil, blamed US forces for Mr Obeidi's death, saying they had changed security arrangements for the lawyers, putting their lives at risk...

...Mr Obeidi was in court on Monday to hear the prosecution team make its closing arguments.

The prosecutors called for Saddam Hussein and two of his seven co-defendants to be put to death for war crimes...

...The trial has so far lasted eight months and has been criticised by some international legal experts.

Some said the defence had been given a disproportionately short period to present its witnesses...

New blood test for diabetes

2006-06-19T10:09:00.000+10:00

Type 2 diabetes mellitus is the scourge of the Westernised world. Humans evolved for tens of thousands of years to be semi-starved. Our physiology has yet to adapt to the veritable glut of high calorie food available to humans in the industrialised world.

Diabetes has traditionally been diagnosed on higher than normal fasting blood sugar levels. However, where the sugar is not very high, an oral glucose tolerance test is often needed – which involves at least two blood tests separated by a couple of hours. Even with this test, there is a proportion of patients with a “normal” test who are at risk or prone to developing diabetes.

Fasting insulin assays can be performed but they can be inaccurate.

Kahn and colleagues at the Beth Israel Deaconess Medical Center in Boston have discovered a new marker for diabetes. The level of “retinol-binding protein 4” (RBP4) seems to be highly correlated with the degree of insulin resistance.

Although it is early days, this test may become highly significant for screening for diabetes and pre-diabetes in the future; being more reliable and convenient than a fasting blood sugar and then oral glucose tolerance test.

Reference article
Graham TE., Yang Q., Blüher M., et al. Retinol-Binding Protein 4 and Insulin Resistance in Lean, Obese, and Diabetic Subjects. NEJM Volume 354(24):2552-2563, June 15, 2006

ABSTRACT
Background
Insulin resistance has a causal role in type 2 diabetes. Serum levels of retinol-binding protein 4 (RBP4), a protein secreted by adipocytes, are increased in insulin-resistant states. Experiments in mice suggest that elevated RBP4 levels cause insulin resistance. We sought to determine whether serum RBP4 levels correlate with insulin resistance and change after an intervention that improves insulin sensitivity. We also determined whether elevated serum RBP4 levels are associated with reduced expression of glucose transporter 4 (GLUT4) in adipocytes, an early pathological feature of insulin resistance.

Methods
We measured serum RBP4, insulin resistance, and components of the metabolic syndrome in three groups of subjects. Measurements were repeated after exercise training in one group. GLUT4 protein was measured in isolated adipocytes.

Results
Serum RBP4 levels correlated with the magnitude of insulin resistance in subjects with obesity, impaired glucose tolerance, or type 2 diabetes and in nonobese, nondiabetic subjects with a strong family history of type 2 diabetes. Elevated serum RBP4 was associated with components of the metabolic syndrome, including increased body-mass index, waist-to-hip ratio, serum triglyceride levels, and systolic blood pressure and decreased high-density lipoprotein cholesterol levels. Exercise training was associated with a reduction in serum RBP4 levels only in subjects in whom insulin resistance improved. Adipocyte GLUT4 protein and serum RBP4 levels were inversely correlated.

Conclusions
RBP4 is an adipocyte-secreted molecule that is elevated in the serum before the development of frank diabetes and appears to identify insulin resistance and associated cardiovascular risk factors in subjects with varied clinical presentations. These findings provide a rationale for antidiabetic therapies aimed at lowering serum RBP4 levels.

Wakefield’s wake – the curse of ego driven research

2006-06-13T10:22:00.000+10:00

Dr Andrew Wakefield, a Canadian trained gastroenterologist has been charged with serious professional misconduct by the General Medical Council in the United Kingdom.

Wakefield’s story is one of intrigue in a field that elicits passion, often irrational. Wakefield published a controversial research article (1) in 1998 in The Lancet linking the MMR (measles, mumps, rubella) vaccine with a form of colitis in children; with a supposition that it was the cause of autism. Wakefield painted himself and has been touted by certain community groups as an anti-MMR (and anti-immunisation) guru, fighting for children against an insidious iatrogenic disease.

Unfortunately, it is almost certainly bogus. There is no convincing evidence that the MMR vaccine causes inflammatory bowel disease or that it causes autism. There is abundant evidence that the MMR vaccine prevents measles, mumps and rubella, three nasty and potentially fatal disease. The Cochrane Database of Systematic Reviews (an organisation that helps collate evidence based medicine and is independent of industry and government) published a review (2) in 2005 to this effect. The Cochrane Library's “plain language summary”:

“Measles, mumps and rubella are three very dangerous infectious diseases which cause a heavy disease, disability and death burden in the developing world. Researchers from the Cochrane Vaccines Field reviewed 139 studies conducted to assess the effects of the live attenuated combined vaccine to prevent measles, mumps and rubella (MMR) in children. MMR protects children against infections of the upper airways but very rarely may cause a benign form of bleeding under the skin and milder forms of measles, mumps and rubella. No credible evidence of an involvement of MMR with either autism or Crohn's disease was found. No field studies of the vaccine's effectiveness were found but the impact of mass immunisation on the elimination of the diseases has been demonstrated worldwide.”

Thankfully in the Antipodes Wakefield’s influence on consumer opinion on childhood immunisation has been slight. In the United Kingdom, however, the effect has been significant. In early 2003, immunisation rates dropped to 78.9% (from 92% in 1996) and had gone to as low as 60% in parts of London. The result was a massive resurgence in the three diseases (for mumps around 4000 cases in 2003 to over 56,000 cases in 2005). In April 2006, a 13 year old boy became the first person in Britain to die from measles in 14 years. He was not immunised with MMR.

Wakefield’s “professional misconduct” is not for his damaging effect on public health, but rather for a gross conflict of interest in his original paper. Wakefield had received £55,000 ($AU 136,000) from the Legal Aid Board paid into his research fund by lawyers representing parents and children allegedly damaged by the MMR vaccine (to look for evidence that would help them in their case). Wakefield had not disclosed this to either The Lancet or to even his co-researchers. In 2004, 10 of his 12 co-authors retracted from the article published in 1998.

Wakefield continues to battle on with his hypothesis that autism is caused by the MMR vaccine.

In the field of biomedicine, perhaps more so than other fields of scientific endeavour, research is often driven by ego; singular dedicated “über-researchers”. For those who are eventually proven right, the rewards are great – retrospectively hailed as visionary and courageous before their sceptical and conservative peers. However, for those who are proven eventually wrong, everything unravels. I believe that Wakefield truly believes in his own cause, much to the harm to his own career, to the medical profession and to the public at large.

Wakefield's dedication and drive blinkered him from keeping an open mind; that his hypothesis could be wrong. His perspective was so skewed that he committed what is an inexcusable lapse of judgement with regards to the non-declaration of the serious conflict of interest.

It is interesting to consider what makes a highly intelligent and dedicated man like Wakefield to lose the founding principles of ethical research.

Money? Fame?

I think not. I wonder whether some of these researchers become so identified with their research and theories that they feel an obligation to themselves, colleagues and patients to “prove it right”. One small lie, accidental perhaps slips through. Then another compounds to another. Another small fabrication slips through, deliberate this time to “tidy up the numbers”. Before they know what has happened, their work is declared visionary and so much momentum has built up that living in the delusion is the only path.

The example is perhaps stark with Dr Hwang Woo-suk, disgraced former top human cloning scientist of South Korea. With much of his most notable research now known to be fabricated it has brought a crushing blow to the field. What is real and what is fake?

It is difficult to know what can be done about this flaw in medical research. Certainly, peer based review is sound – insofar that there is nothing better than can replace it. Perhaps, what needs to be addressed is the culture of medicine and biomedical research. Hierarchical deference to seniors and professors is certainly a factor as to why occurrences of scientific misconduct or outright fraud are discovered so late. This is illustrated particularly in the South Korean scandal.

I believe that the only way to shake the “curse of ego-driven research” is for a culture of egalitarianism to be developed within the profession.

Research articles
(1) Wakefield AJ. Murch SH. Anthony A. Linnell J. Casson DM. Malik M. Berelowitz M. Dhillon AP. Thomson MA. Harvey P. Valentine A. Davies SE. Walker-Smith JA. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. [Journal Article. Retracted Publication] Lancet. 351(9103):637-41, 1998 Feb 28. [download PDF : 335 Kb]

(2) Demicheli V, Jefferson T, Rivetti A, Price D. Vaccines for measles, mumps and rubella in children. The Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD004407 [download PDF : 277 Kb]

Source articles:
The Independent: In the dock: the man who caused the great MMR scare

Wikipedia: Andrew Wakefield

The Sunday Times: Schoolboy, 13, dies as measles makes a comeback

Wikipedia: Hwang Woo-Suk

BBC News: S Korea cloning research was fake

The stench of Guantanamo

2006-06-12T13:40:00.000+10:00

Something is rotten in the United States. It is the stench of moral decay. It reeks of degraded principles, of hyporcrisy, and of ethical stagnation. There is also more than a whiff of fascism.

Three detainees died yesterday at the Guantanamo Bay camp, two Saudis and a Yemeni. They had apparently committed suicide by hanging themselves with clothing and bed sheets. All three had been held in the camp for years without charge. This had hardly been an isolated incident either. Since January 2002, Guantanamo officials claim that there have been 41 suicide attempts though defence lawyers believe that number to be much higher.

Amongst renewed criticism by both international and domestic US parties for the camp to be closed, the commander of the camp, Rear Admiral Harry Harris Jr. had the audacity to state:

“I believe this was not an act of desperation, but an act of asymmetrical warfare waged against us.”

How dare he reframe this tragic situation to make the United States the victim and the detainees the aggressors? It is offensive and absolutely disgusting. If the United States military upheld any sort of moral principle, it would repudiate these odious comments immediately and censure Harris.

The reasons why these three men were driven to suicide is not a mystery. There is no hidden reason or greater plan. As per Kenneth Roth, head of the Human Rights Watch in New York:

“These people are despairing because they are being held lawlessly … There’s no end in sight. They’re not being brought before any independent judges. They’re not being charged and convicted for any crime.”

As before, there should really be no reason why this turn of events was unexpected. There had already been 41 attempts of suicide previously and an unsuccessful attempt should be taken just as seriously.

This article has been republished on the mixeye website, and is available here.

Source articles:
Yahoo! News: DOD identifies 3 Guantanamo suicides

Yahoo! News: U.S.: 3 Gitmo inmates hanged themselves

BBC News: Triple suicide at Guantanamo camp

BBC News: Guantanamo suicides ‘acts of war’

Persecution of the Palestinians

2006-06-11T14:27:00.000+10:00

Israel, Hamas and the spiral of violence

Friday bore fruit to the futility of Israel’s overwhelming militaristic response to Palestinian resistance. Israeli shells hit a beach in the northern Gaza Strip, killing 10 people, including 3 children and injuring 30.

The targeting of civilians in military activities is condemned as a form of terrorism. Indiscriminate or incompetent use of heavy arms within an urban area I consider to be morally equivalent. This tragedy is little more than a particularly bloody example of terrorism against the Palestinian public by the Israeli military.

If words are to be believed, the goal of Israel is to live peaceably with a neighbouring Palestinian state. How then, is this goal being accomplished by the military response against Palestinian militants?

For 18 months, the paramilitary and political group Hamas has kept a ceasefire. Israel, however, has not kept up its end of the “truce”, launching frequent military action into Palestinian territory. Although it is accepted that these are mostly in response to suicide bombings launched by other Palestinian groups, this displays a significant lack of “temperance” in the part of the Israelis. For 18 months, Hamas has tolerated “just” Israeli incursions while Israeli has repaid Hamas with criticism and disdain of its political authority.

Israel’s immediate withholding of the Palestinian Authority’s share of tax and customs revenue, along with the withdrawal of aid by the US and Europe (reference) after the victory of Hamas in the Palestinian elections has crippled the Palestinian state. Public servants, along with a large contingent of armed security personnel have not been paid for months. No matter how politicians try to reframe the situation, Israeli and U.S. policy is punishing the Palestinian people for their democratic choice.

One must ask the question, “for what purpose”?

If it is to “encourage” (coerce) the Palestinian public to drop their support for Hamas, then this policy of economic terrorism is a clear failure. Hamas has become ever more popular amongst the poor and disenfranchised.

After Hamas swept into power, there was a small window of opportunity that was lost to mutual belligerence. Within the model of its own political ideology, it had stretched out a hand to the Western community; coming as close as what could be expected for recognising Israel (considering one of its founding goals is for the destruction of the Jewish state). This was firmly rebuffed by both Israel and the United States with the proclamation that unless Hamas renounced violence and recognised the right for Israel to exist, that there would be no negotiation.

Although this may seem “reasonable” to the casual observer, it is bound in hypocrisy. Israel after all, has never denounced the use of “violence” upholding the use of extreme military force for the purposes of “protecting itself”. Furthermore, significant parts of Israel that they would have the Palestinians recognise is founded on stolen and occupied land; of which Israel is in breach of several UN Security Council Resolutions.

In a remarkably clear minded essay, American right wing conservative Patrick Buchanan states:

“The purpose of U.S.-Israeli policy today is to punish the Palestinians for how they voted and to force Hamas to yield or to collapse its government… Terrorism has been described as waging war on innocents to break their political leaders. Is that not a fair description of what we are doing to the Palestinians?”

At the end of the day, it is almost pointless apportioning blame. Both sides are at fault. Nevertheless, as the overwhelmingly dominant side and the occupying force, Israel has the ability and thus the responsibility to establish peaceful relations with the Palestinians.

On Friday, June 9 2006, the “regrettable mistake” of the senseless slaughter of civilians at a picnic on a beach finally broke the ceasefire that had held back Hamas’ hand for a year and a half. The cycle of violence continues and all the while it is the Palestinian public that suffers.

Source articles:
The American Conservative: The Persecution of the Palestinians, by Patrick Buchanan

BBC News: Palestinians killed on Gaza beach

Yahoo! News: Hamas ends truce with Israel amid Abbas showdown

Middle East News: List of United Nations Resolutions Against Israel (1955-1992)

Council on Foreign Relations: Hamas and the Shrinking PA Budget

John Bolton, a stereotype

2006-06-10T22:54:00.000+10:00

The anti-diplomat

The diplomat; the term conveys the vision of a highly intellectual individual, knowledgeable in international affairs and politics, multilingual, able to defuse tense situation with a clever speech or phrase.

Then we have John Bolton, the U.S. ambassador to the United Nations; an anti-diplomat if there ever was one. John Bolton fits the right wing imperialist American stereotype. Loud, stupid, crass, “pro-America and the rest of the world be damned”.

Quotations of from this questionable man:

“There is no such thing as the United Nations. There is only the international community, which can only be led by the only remaining superpower, which is the United States.” (1994)

“There is no such thing as the United Nations. United States makes the U.N. work, when it wants it to work.” (1994)

“… the United Nations can be a useful instrument in the conduct of American foreign policy.” (1997)

It is almost obscene that this man is now an ambassador to the United Nations. John Bolton’s contempt for the United Nations as an organisation represents a larger view of US foreign policy. It is contempt for world opinion that contradicts the goals of American hegemony. The United States does not want to “work with” the global community, it wants to run it.

Bolton’s attack on the UN came renewed this week following a speech by Mr Malloch Brown, deputy secretary general of the UN. In the speech, Mr Brown stated that the United States did not defend that United Nations against its domestic critics and that “public discourse that reaches the US heartland has been largely abandoned to its loudest detractors, such as Rush Limbaugh and Fox News”. Furthermore, that “too much unchecked UN-bashing and stereotyping” was “simply not sustainable” and that “you will lose the UN one way or another”.

In essence, common sense. Nevertheless, the hyperbole of Bolton knows no bounds with his proclamation that “I think this is … probably the most severe political mistake that any high official of the UN has made…”

Brown responds:

“Engage here, engage consistently and go out and engage with the American public to say the UN matters, and for the life of me, I can’t understand how that can be construed as an anti-American speech.”

John Bolton – another in the party of dangerous fools. He is well kept in the company of Bush, Cheney, Rumsfeld and Rice.

From: BBC News

Implant gives a magnetic touch

2006-06-10T21:37:00.000+10:00

Freaky, possibly stupid, but cool.

Many animals have an innate magnetic sense; bees, pigeons, sharks, turtles. The magnetic sense allows these animals to detect the alignment of the Earth’s magnetic field. With this internal compass, these animals are able to travel extreme distances from a human perspective.

An article recently published in Wired describes the exploits of an eclectic group of “body-mod artists” and a graduate student with a background in neuroscience. When freaky art meets geeky science, much craziness ensures!

Jarrell and Haworth (body-mod artists) and Huffman (the graduate student) decided to devise an implant that would give Huffman the ability to detect electromagnetic fields. A small rare earth magnet encased in silicone was implanted into the fingertip of Huffman’s ring finger.

The result? Says Huffman:

“I would circle my finger with a strong magnet and feel the one in my finger spin. In time, bits of my laptop became familiar as tingles and buzzes. Every so often I would pass near something and get an unexpected vibration. Live phone pairs on the sides of houses sometimes startled me.”

Although this is absolutely fascinating from a neuroscience point of view, the crazy part is that they couldn’t get someone with even an inkling of medical training involved. The eventual failure of the implant is proof. By using low grade silicone, it was eventually broken down by the body. Infection around the implant ensured. An attempt to extract the implant failed, shattering the magnet in the process; though interestingly enough, it reassembled in situ leading to a reconstitution of the “magnetic sense”.

Although this “fringe” of art and science can barely be called either art or science, it pushes the envelope of human experience. Modern technology has allowed humans to have extraordinary sense and abilities. Laser corrective surgery can already regularly deliver better than 6/6 or 20/20 vision. An electromagnetic sense would probably be extremely useful in a world dominated by electronic devices.

From: Wired News

American-style democracy revisited

2006-06-06T14:12:00.000+10:00

Democracy Lost

In April 2006, I wrote a damning article on the state of the American democracy. For a state that purports “exporting democracy” as part of its foreign policy platform, the democratic process within the domestic United States seems rather lacking.

As part of that article, I compared the election of Bush (2000) as compared to the Iranian President, Mahmoud Ahmadinejad (2005). Though the Iranian elections are hardly “fair” by Western standards, they compare in a surprisingly favourable manner to the Bush vs. Gore election. At the end of the day, the Iranian election of 2005 had a much higher participation rate, and Ahmadinejad won by a decisive majority. Bush, even ignoring the claims of procedural biases (if not outright electoral fraud) was not a “popularly elected” leader as Gore actually won more votes.

Earlier this month, Rolling Stone Magazine published a well researched political piece, “Was the 2004 Election Stolen?” by Robert F Kennedy Jr (son of the late “Bobby Kennedy”). Although the article has been criticised by some commentators (here, and here), there is nevertheless an essentially hitherto uninvestigated core of fact that should be ringing alarm bells.

The most pertinent part of Kennedy’s article is the section that is most grounded in fact – one that cannot be dismissed as a “conspiracy theory”; exit polls.

Exit polls ask voters leaving the voting booth on the decision they have just made. As such, exit polls are the most accurate of election predictors. According to Kennedy’s article (and his references), exit polls in Germany in recent elections have always been within 0.3% of the actual result. They are so accurate that they have also been used as de facto indicators of electoral fraud – used to good effect in the election in the Republic of Georgia in 2003 and the Ukrainian election in 2004.

The relevant excerpts from Kennedy’s article:

“The first indication that something was gravely amiss on November 2nd, 2004, was the inexplicable discrepancies between exit polls and actual vote counts. Polls in thirty states weren’t just off the mark – they deviated to an extent that cannot be accounted for by their margin of error. In all but four states, the discrepancy favored President Bush...

… the exit poll created for the 2004 election was designed to be the most reliable voter survey in history…

For its nationwide poll, Edison/Mitofsky selected a random subsample of 12,219 voter – approximately six times larger than those normally used in national polls – driving the margin of error down to approximately plus or minus one percent…

…On the evening of the vote, reporters at each of the major networks were briefed by pollsters … Kerry … had an insurmountable lead and would win by a rout: at least 309 electoral votes to Bush’s 174, with fifty-five too close to call…

… as the evening progressed, official tallies began to show implausible disparities – as much as 9.5 percent – with the exit polls. In ten of the eleven battleground states, the tallied margins departed from what the polls had predicted. In every case, the shift favoured Bush…

… In its official postmortem report issued two months after the election, Edison/Mitofsky was unable to identify any flaw in its methodology…

… [Steven F.] Freeman [a visiting scholar at the University of Pennsylvania who specialises in research methodology] found, the greatest disparities between exit polls and the official vote count came in Republican strongholds. In precincts where Bush received at least eighty percent of the vote, the exit polls were off by an average of ten percent. By contrast, in precincts where Kerry dominated by eighty percent or more, the exit polls were accurate to within three tenths of one percent…

… ‘When you look at the numbers, there is a tremendous amount of data that supports the supposition of election fraud,’ concludes Freeman. ‘The discrepancies are higher in battleground states, higher where there were Republican governors, higher in states with greater proportions of African-American communities and higher in states where there were the most Election Day complaints. All these are strong indicators of fraud – and yet this supposition has been utterly ignored by the press…’”

The remainder of Kennedy’s article detail how this electoral fraud took place. The criticisms to Kennedy’s article all revolve around picking at side issues that I freely agree that Kennedy could be mistaken in. Nevertheless, the facts remain – there is incontrovertible proof that a widespread electoral miscount occurred in the US presidential election of 2004 with it overwhelmingly favouring Bush. This evidence was provided by the most elaborate and accurate exit poll ever devised. The “true count” would almost certainly have elected John Kerry as president.

Bush is an illegitimate president twice over. More than that, the state of the American democracy is in complete disarray. What use is the “freedom of the press” when the popular press self-censors itself to such a degree?

From: Rolling Stone Magazine

Immigration department – the dog of politics

2006-05-29T12:21:00.000+10:00

The Australian Department of Immigration has become our own national “symbol of injustice” under the Howard Government. In the past decade, it has become a politicised tool executing the dogma of the Coalition parties.

Under this government, some of the worst examples of political opportunism and deceit have involved the Department of Immigration.

“Children overboard” scandal
The Howard Government demonised asylum seekers claiming that they had thrown their children overboard in a “tough stance” against illegal immigration and border security. This had not actually occurred. The Navy further denied ever giving intelligence to the Government that children had been thrown overboard exposing the politically convenient fabrication by Howard and his senior ministers.

The “Tampa” case
The highly accoladed Arne Rinnan, captain of the Norwegian ship, the MV Tampa rescued approximately 450 asylum seekers from a leaking boat approximately 75 nautical miles from Christmas Island. The Tampa was ordered to stop a few miles off Christmas Island. The port was closed and the Tampa boarded by the SAS (an elite army unit). This “get tough” platform appealed to right wing popularism in the electorate of the time and won Howard the 2001 election.

“The government’s handling of the Tampa “crisis” was a triumph of electoral cynicism over humanitarian need”. [Julian Burnside]

The “Cornelia Rau” scandal
A mentally unwell Australian citizen (with psychosis) was kept for two years in the Baxter Detention Centre (for illegal immigrants), denied routine psychiatric care while the Department of Immigration tried to deport her to Germany. Even trivial investigation into her case would have revealed her true identity.

The “Vivian Solon” scandal
Another Australian citizen who was seriously unwell after a motor vehicle accident where she suffered spinal and brain injuries was deported to the Philippines. After the Department of Immigration realised its mistake, it tried to cover up the fact.

Now, a new entry to that list is the case of Ahmed Aziz Rafiq, an Adelaide supermarket worker who was wrongfully imprisoned by the U.S. forces in the infamous Abu Ghraib prison for 18 months – eventually released without charge. Rafiq had returned to Iraq to find a bride in 2004. Since his release, Rafiq has been unable to return to Australia as the Department of Immigration has yet to issue his wife with a visa! Somehow, the assurance from an Immigration spokesman that “every effort to finalise this application as quickly as possible” was being made seems hollow.

Source articles:
Project Safecom: The Unthrown Kids

Julian Burnside. Refugees: The Tampa Case

The Sydney Morning Herald: Cornelia Rau: the verdict

The Sydney Morning Herald: A culture of denial

From: The Sydney Morning Herald
Immigration delay leaves Abu Ghraib prisoner in limbo (excerpt)
May 24, 2006

...AN AUSTRALIAN wrongfully detained in Iraq's notorious Abu Ghraib prison for more than 18 months without charge has been unable to return home because the Immigration Department has not given his wife a visa.

Ahmed Aziz Rafiq, an Adelaide supermarket worker, had just married his wife, Sarab, in Iraq when he was arrested by the US military in February 2004.

A year later, the US promised to release him but it withdrew the offer, saying it wanted to gather more information. He was not freed until last October after an Iraqi court found there was no evidence to prosecute him...

...Upon his release, the Australian embassy in Baghdad told him it could not issue a visa for his wife...

...A spokesman for the Immigration Department insisted it was making "every effort to finalise this application as quickly as possible". He said Mr Rafiq was free to return home without his wife, if he chose. Mr Rafiq's lawyer, Stephen Kenny, said this was not an option: "He's clearly very nervous about leaving [Sarab] in Iraq, and understandably so..."

Signing statements – a most undemocratic tool

2006-05-27T16:38:00.000+10:00

The "razor wire" of democratic law

U.S. President George W Bush is famous for not using his power of veto on new legislation passed by the American Congress. Though this is often glibly interpreted by his supporters as proof of his non-interference with the running of government, the truth is rather more sinister.

Rather than using the power of veto to openly oppose new legislation, Bush has issued “signing statements” on more than 750 new laws since taking office in 2001. Signing statements have been used by American presidents to add their own thoughts to the legislation when they don’t feel inclined to veto. However, Bush has used signing statements in such a fashion that effectively nullifies legislation that he disagrees with – and he has done so on a wide swath of legislation. Bush has in an underhand manner vastly expanded the boundaries of “executive power” taking both the powers law maker and the interpretation of law. To this end, Bush has issued more signing statements than all previous presidents; in fact, more than many combined.

Particularly obscene examples of his signing statements (from The Boston Globe):

March 9: Justice Department officials must give reports to Congress by certain dates on how the FBI is using the USA Patriot Act to search homes and secretly seize papers.

Bush’s signing statement: The president can order Justice Department officials to withhold any information from Congress if he decides it could impair national security or executive branch operations.

Dec. 30, 2005: US interrogators cannot torture prisoners or otherwise subject them to cruel, inhuman, and degrading treatment.

Bush’s signing statement: The president, as commander in chief, can waive the torture ban if he decides that harsh interrogation techniques will assist in preventing terrorist attacks.

Dec. 30: When requested, scientific information “prepared by government researchers and scientists shall be transmitted [to Congress] uncensored and without delay.”

Bush’s signing statement: The president can tell researchers to withhold any information from Congress if he decides its disclosure could impair foreign relations, national security, or the workings of the executive branch.

Dec. 23, 2004: Forbids US troops in Colombia from participating in any combat against rebels, except in cases of self-defense. Caps the number of US troops allowed in Colombia at 800.

Bush’s signing statement: Only the president, as commander in chief, can place restrictions on the use of US armed forces, so the executive branch will construe the law “as advisory in nature.”

Oct. 29: Defense Department personnel are prohibited from interfering with the ability of military lawyers to give independent legal advice to their commanders.

Bush’s signing statement: All military attorneys are bound to follow legal conclusions reached by the administration’s lawyers in the Justice Department and the Pentagon when giving advice to their commanders.

Aug. 5: The military cannot add to its files any illegally gathered intelligence, including information obtained about Americans in violation of the Fourth Amendment’s protection against unreasonable searches.

Bush’s signing statement: Only the president, as commander in chief, can tell the military whether or not it can use any specific piece of intelligence.

Nov. 5, 2002: Creates an Institute of Education Sciences whose director may conduct and publish research “without the approval of the secretary [of education] or any other office of the department.”

Bush’s signing statement: The president has the power to control the actions of all executive branch officials, so “the director of the Institute of Education Sciences shall [be] subject to the supervision and direction of the secretary of education.”

The pattern of Bush’s subversion of legislation is clear and distinct. The security agencies and the military are given leave of their obligations of disclosure to Congress (i.e., the elected representative of the people) on Bush’s will – i.e., formation of a secret police. Bush’s statement that his government “did not torture” has an unuttered proviso of “unless directed by me” and then no one can report it afterwards. Time and time again, independence and transparency are stripped away with power directed towards the presidency.

Source article:
The Boston Globe: Examples of the president’s signing statements

Human to human bird flu in Indonesia?

2006-05-27T15:32:00.000+10:00

Sumatra, Indonesia

So far, the H5N1 avian influenza virus has killed only a limited number of people. Transmission remains within those who have had close and prolonged contact with infected birds.

However, in the past week, it has been reported that there has been seven fatal human cases of bird flu within the same family with a family member as a suspected eighth case. The recent deaths occurred in Sumatra, Indonesia. The World Health Organisation has reported that there was no sign of diseased poultry in the immediate area.

In such a circumstance, human to human transmission must be suspected though from reports it does not seem that an outbreak beyond the known victims has occurred. Will Sumatra be “ground zero” for pandemic human influenza?

From: New Scientist

Bird flu may have passed between family members (excerpt)

15:48 24 May 2006
NewScientist.com news service
NewScientist.com Staff and AFP

...Limited human-to-human transmission of bird flu may have occurred in an Indonesian family which lost seven members to the virus. But there is no evidence that it had mutated into an easily transmissible form, the World Health Organization said on Wednesday.

The seven fatal cases in north Sumatra – the largest human cluster of infections in Indonesia – caused heightened fears that the H5N1 virus had passed between people...

...A WHO spokesman said there was no sign of diseased poultry in the immediate area. Although human-to-human transmission could not be ruled out, the search for a possible alternative source of exposure continues...

The failure of empire

2006-05-25T23:36:00.000+10:00

Throughout history, only a select number of nations have had the overarching power militarily and economically on such a scale to be considered a global empire. The Roman Empire comes to mind, as does the more recent British Empire. Economic and social dominance is perhaps more important than military might for an enduring empire. Though, the classical Greeks under Alexander and the Mongols under Genghis Khan conquered vast territory and had a lasting legacy in history, did not form a “stable” empire beyond their creators or their immediate descendents.

The United States of America, the one “superpower” left in the modern world is arguably the current global empire. Its political will shapes the landscape of world affairs. Its military might (on almost any metric) dwarfs its closest rivals. Cultural dominance is pervasive internationally. Economically, it is the single largest market in the world. The United States (rightly or wrongly) is unashamed as the global policeman. Its foreign policy goal of attaining American hegemony is accepted (begrudgingly) as a political norm.

It is then perhaps interesting to highlight certain inconsistencies in the American empire. Many Americans that I have met are comfortable, if not smug in the belief that they live in the “best” nation of the world. Indeed, many are shocked that non-Americans do not think so. This “incomprehensible” blow is manifest throughout American news media. It is represented by denouncements of “anti-Americanism” in Europe (a good example by CNN).

This may all be true if the United States really is the “best” nation on Earth. It is established that the political, military, economic and culture dominance of the United States is real in the international sphere. What cost has this had on America itself? Interestingly, the United States fails in virtually all domestic metrics.

Education

The United States is 49th in the world in literacy (the New York Times, Dec. 12, 2004).
The United States ranked 28th out of 40 countries in mathematical literacy (NYT, Dec. 12, 2004).
20% of Americans think the sun orbits the earth and 17% believe the earth revolves around the sun once a day (The Week, Jan. 7, 2005). That is, about 2 in 5 don’t know primary school level science.
The International Adult Literacy Survey found that Americans with less than nine years of education ‘score worse than virtually all of the other countries’ (The European Dream: How Europe’s Vision of the Future Is Quietly Eclipsing the American Dream, p.78 by Jeremy Rifkin).
The European Union leads the U.S. in the number of science and engineering graduates, public research and development (R&D) expenditures, and new capital raised.
Europe surpassed the United States in the mid-1990s as the largest producer of scientific literature.

Health

The World Health Organization “ranked the countries of the world in terms of overall health performance” and the U.S. 37th. In the “fairness of health care”, the U.S. was 54th.
The United States spends more per capita for health care than any other nation in the world.
The U.S. and South Africa are the only two developed countries in the world that do not provide health care for all their citizens.
Lack of health insurance coverage causes 18,000 unnecessary American deaths a year (NYT, Jan. 12, 2005).
U.S. childhood poverty ranks 22nd, or second to last, among the developed nations.
The United States is 41st in the world in infant mortality. Cuba scores higher (NYT, Jan. 12, 2005).
Women are 70% more likely to die in childbirth in America than in Europe (NYT, Jan. 12, 2005).

Industry

Sixty-one of the 140 biggest companies on the Global Fortune 500 rankings are European, while only 50 are U.S. companies.
Fourteen of the 20 largest commercial banks in the world today are European.
In engineering and construction, three of the top five companies are European. The two others are Japanese. Not a single American engineering and construction company is included among the world’s top nine competitors.
In food and consumer products, Nestlé and Unilever, two European giants, rank first and second, respectively, in the world.
In the food and drugstore retail trade, two European companies are first and second.

Trade

Japan, China, Taiwan, and South Korea hold 40% of U.S. government debt.
Sometime in the next 10 years Brazil will probably pass the U.S. as the world’s largest agricultural producer.
As of June 2005, the U.S. imported more food than it exported (NYT, Dec. 12, 2004).

Domestic politics

Voter participation rate around 50%, one of the lowest rates in the developed world. Western Europe average is 77%.

The pursuit of the American “empire” has failed ordinary Americans in terms of domestic development and progress. One would rightly assume that American dominance in the world stage would push domestic measures to world best (if not near best). Nevertheless, this is clearly not the case and domestic American ignorance to the contrary is a well cultured delusion by the U.S. Administration and compliant domestic news media.

Source article:
Minneapolis/St. Paul City Pages: America by the numbers – No. 1?

Howard blames Hicks for detention without trial

2006-05-19T10:37:00.000+10:00

Earlier this month I argued that Guantanamo Bay was both a symbol and actuality of injustice in the Western world. To this point, though it has been a steadfast partner in the “coalition of the willing”, the United Kingdom concurs and has extricated all British citizens from this “gulag”.

International consensus includes most governments of Western nations, the United Nations, and NGOs such as the Red Cross.

Indeed, there is much criticism of the legality of the camp within the legal and judicial fraternity within the United States.

Our illustrious Prime Minister John Howard, however, has been unwavering in his support for American foreign policy. In an incredibly narrow minded attack on Hicks, he puts the blame of being held without trial on Hicks himself. He states:

“The circumstance delaying his trial by military commission is a legal action in the American courts… Until that is resolved the military commission trial can't go ahead… We do not want him to come back to Australia until he's been tried before the military commission.”

Howard’s argument is that Hicks is responsible for his own continued detention as he does not want to go through a biased show trial, one that has been condemned internationally as fundamentally lacking in fairness.

States Hicks’ excellent military lawyer, Major Michael Mori:

“If the military commission process was fair as [Mr Howard] likes to say it is, then the US courts would not entertain any legal challenges.”

There is a difference between a friend and a toady. I believe that Australia is a friend to the United States. Real friends, however, should stop each other from committing atrocities. John Howard is morally bankrupt, a toady lapping at the reflected glory of the power of the United States.

From: Sydney Morning Herald