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Wednesday, September 23, 2009

If Evolution Isn't Directed, Why Is Life Now More Complex Than in Ancient History?

A common misconception about evolution is that it has a goal, that organisms evolve from lower to higher forms. This is sometimes referred to as the Ladder or Progress, with primitive forms at the bottom and more advanced forms towards the top of the ladder (and commonly, being the self centered species that we are, with humans on the top rung). This isn't true. Evolution has no direction. Organisms adapt to fit their local environment in whatever way works best. But if evolution has no direction, why is it that life now is more complex* than life from billions of years ago?

This really is pretty easy to understand once you give it a little thought. Let's use distance as an analogy. There's an old saying, that the journey of a thousand miles begins with a single step. You can't walk from Los Angeles to New York instantly. It takes many, many small steps (literally in this example) to get there. If we consider Los Angeles to be simple, and New York to be complex, then at any point on your journey, as you've increased your distance from LA, you've increased your complexity. And it's obvious that you can't get to a certain point of complexity until you've already taken all the previous steps leading up to it. You can't just instantly go from simple to complex.

But a journey still implies direction, and I've said evolution doesn't work that way. Evolution is more like a drunkard's stagger. If you have a drunk that starts out in LA, and let him wander aimlessly with no particular destination in mind, he may eventually end up in New York, but it definitely wouldn't be a straight line. He may just as likely never make it to New York, and never even leave LA. To extend the analogy further, he may end up in Seattle. He'd still be a long way from LA, but in a completely different direction. Squids, for example, are remarkably complex, but they took a different path to their complexity than us vertebrates, and their resulting complexity is different from ours.

Below is a graph that roughly illustrates this in an evolutionary context. It starts off at zero, and for every step, it goes up or down by a random amount** between -0.5 and 0.5. After every 10 steps, it splits, and each new 'lineage' then varies in that same manner. This was carried on for 40 steps, resulting in 8 lineages by the end.

Random Distribution Simulating Evolution of Complexity

Remember, this is all random variation from a starting point at zero, going in small steps. After 40 steps, one lineage had varied to more than 3.4 away from zero, while other lineages didn't vary very much away from zero at all. If this was representing complexity, and if the steps were assumed to be thousands or millions of generations, it demonstrates how complexity can evolve slowly from simple beginnings, without any conscious aim toward increased complexity. (As I said, this is only a rough illustration of evolution. Evolution is driven by more than just random variation, and the divergence of lineages isn't as predictable as that.)

Evolution really does sometimes decrease complexity. For an intimate example, consider what you're sitting on - a nice smooth posterior. Some time millions of years ago, our ancestors lost their tails, a complex feature with muscles, bones, and tendons. Their lifestyles were probably such that a tail just didn't really do that much good, so there was no reason for natural selection to maintain it. And now, we have backsides that are less complex than our simian ancestors.

*'Complex' is actually a little hard to define. How exactly do we mean complex? Number of genes? Number of specialized cell types? How do we even differentiate specialized cell types? (more info) This seems like one of those problems where we know it when we see it. I think most people would agree that a mammal is more complex than an earthworm, even without a quantitative definition of that complexity.

**Technically, a pseudo random number generator was used (Visual Basic). For this application, that's close enough to truly random.

Tuesday, September 15, 2009

A Skeptical Look at Bio-Identical Hormone Replacement Therapy

CaduceusA few weeks ago, my wife attended a presentation by a local doctor and a local pharmacy on something called bio-identical hormone replacement therapy (BHRT). (If you've read this blog before, guess which pharmacy.) The presentation sounded mostly reasonable, but a few things that were said didn't sit quite right with my wife, so she asked me to use my Google skills to research it a bit for her. I'm not a doctor, but I have a healthy skepticism. And when professional organizations with the appropriate expertise express concerns over specific treatments, I become even more skeptical of claims of proponents of those treatments.

Before getting into everything that I found, here's the bottom line. Conventional hormone replacement therapy carries risks, but may be worth it for the patient. That's up for the patient and their doctor to decide. Bio-identical hormone replacement therapy doesn't appear to be significantly safer, if at all, compared to conventional hormone replacement therapy. After more trials and research, it may turn out that BHRT is slightly better than conventional HRT, but somebody needs to do the work to determine that, first. If someone's considering hormone replacement therapy, they shouldn't buy into claims that the bio-identical variety is safer, and shouldn't let those claims influence their decision on whether or not to use hormone replacement therapy.

My gut feel is that the people making the claims about BHRT are full of it. I've always been skeptical of the people who think 'natural' means safer (remember that cyanide and snake venom are natural, too), and that seems to be one of the main arguments for BHRT. The pamphlets promoting BHRT even had some statements about how pharmaceutical companies won't research BHRT because there's no profit in it, which of course set off my BS detectors, since it just rings of a conspiracy theory. Any doctors or pharmacies making unfounded claims about the benefits of BHRT are, in my opinion, being dishonest.

Anyway, I looked up a few sites to see what people had to say about BHRT and compounded BHRT. Here's what I found.

First of all, there's an article from Skeptic magazine, The double-blind gaze: how the double-blind experimental protocol changed science, which I highly recommend for background on understanding the importance of evidence based medicine. Here's part of the introduction of that article.

Why Double-Blind Studies?

The experience of the last forty years has shown that, for most types of medical treatments, only a randomized double-blind, placebo-controlled study can properly answer the deceptively simple question: "Does Treatment A benefit Condition B?"

Commonsense says that it's easy to tell if a treatment works--simply try it. However, in this case, common sense is wrong. Unblinded observation allows one to draw valid conclusions only in the case of "high effect size treatments." A high effect-size treatment is one that, in nearly all subjects, causes effects that lie entirely outside the range of normal variation of that subject. To test the hypothesis "will a quart of hard liquor cause drunkenness?" one would not need a double-blind study. The behavior and physiology of a person who has consumed that much alcohol are sufficiently different from the behavior and physiology of a person who has not consumed alcohol, that simple observation would be sufficient to verify the hypothesis.

A number of medical treatments fall into the high effect-size category: for example, appendectomy for appendicitis, penicillin for streptococcal pneumonia, vitamin C for scurvy, anesthetics to produce unconsciousness, and defibrillation for restoring heart function. However, for many medical treatments, the subjective and objective signs of untreated individuals overlap considerably with those of treated individuals. People who have an ankle sprain may experience a reduction of symptoms when they take ibuprofen, for example, but not the elimination of symptoms; furthermore, ankle sprain symptoms change from moment to moment and are affected by state of mind. This type of fluid, inconsistent data turns out to be very difficult to appraise accurately. Only double-blind studies are up to the job.

Confounding Factors

Subtle influences called "confounding factors" can easily create the illusion of efficacy when an ineffective treatment is used. Consider the practice of "letting blood," a technique that endured for many centuries, and reached its heyday in the 17th and 18th centuries. The medical literature of Enlightenment-era Europe is full of testimonials to the marvelous effect of slitting a vein. Today, it's clear that bleeding is not helpful, and no doubt was responsible for killing a great many people.

Why did bloodletting survive so long? Not because the people who used it were stupid, dishonest, or unobservant--the greatest minds of the time were certain that letting blood was a medical necessity. The practice endured because they saw benefits from it. If one begins with the assumption that a treatment is helpful, one is highly likely to observe benefits by using it. Such misleading observations are ensured by the following confounding factors (among others):

  • The Placebo Effect
  • The Re-interpretation Effect
  • Observer Bias
  • Natural Course of the Illness
  • Regression to the Mean
  • The Study Effect (Hawthorne Effect)

That article has quite a bit more information, and I'd highly recommend reading the whole thing.

Considering these confounding factors, it's very difficult to tell whether treatments are effective without doing an actual clinical trial with a control group to compare to. Given the lack of clinical studies I've seen for BHRT, I'm very skeptical of any claimed benefits relative to convention HRT.

Moving on to what people have written specifically about BHRT...

Here's a good article from the FDA. I don't normally do this, but I simply quoted their whole article since it was so good:

Bio-Identicals: Sorting Myths from Facts

"A natural, safer alternative to dangerous prescription drugs"

"Can slim you down by reducing hormonal imbalances"

"Prevents Alzheimer's disease and senility"

All of these claims have been made by marketers of compounded "bio-identical" hormones, also known as "bio-identical hormone replacement therapy" (BHRT). But these claims are unproven. FDA is concerned that claims like these mislead women and health care professionals, giving them a false sense of assurance about using potentially dangerous hormone products.

FDA is providing the facts about "BHRT" drugs and the uncertainties surrounding their safety and effectiveness so that women and their doctors can make informed decisions about their use.

"BHRT" is a marketing term not recognized by FDA. Sellers of compounded "bio-identical" hormones often claim that their products are identical to hormones made by the body and that these "all-natural" pills, creams, lotions, and gels are without the risks of drugs approved by FDA for menopausal hormone therapy (MHT). FDA-approved MHT drugs provide effective relief of the symptoms of menopause such as hot flashes and vaginal dryness. They also can prevent thinning of bones. FDA has not approved compounded "BHRT" drugs and cannot assure their safety or effectiveness.

During menopause, a woman's body produces less of the hormone estrogen, which may lead to hot flashes, vaginal dryness, and thin bones. MHT drugs contain estrogen or a combination of estrogen and another hormone, a progestin. FDA-approved MHT drugs are sold by prescription only, and FDA advises women who choose to use hormones to use them at the lowest dose that helps, for the shortest time needed.

Some "BHRT" drugs are compounded in pharmacies. Traditional compounding involves combining, mixing, or altering ingredients by a pharmacist, according to a prescription from a licensed health care professional, to produce a drug that meets an individual's special medical needs. FDA considers traditional compounding to be a valuable service when used appropriately, such as customizing a drug for someone who is allergic to a dye or preservative in an FDA-approved medicine. But some pharmacies that compound "BHRT" drugs make unsupported claims that these drugs are more effective and safer than FDA-approved MHT drugs.

FDA is taking action against pharmacies that make false and misleading claims about "BHRT" drugs and is encouraging consumers to become informed about these products and their risks. Here is some information to help sort the myths from the facts:

Myth: "Bio-identical" hormones are safer and more effective than FDA-approved MHT drugs.

Fact: FDA is not aware of any credible scientific evidence to support claims made regarding the safety and effectiveness of compounded "BHRT" drugs. "They are not safer just because they are 'natural,'" says Kathleen Uhl, M.D., Director of FDA's Office of Women's Health.

Drugs that are approved by FDA must undergo the agency's rigorous evaluation process, which scrutinizes everything about the drug to ensure its safety and effectiveness—from early testing, to the design and results of large clinical trials, to the severity of side effects, to the conditions under which the drug is manufactured. FDA-approved MHT drugs have undergone this process and met all federal standards for approval. No compounded "BHRT" drug has met these standards.

Pharmacies that compound these "BHRT" drugs may not follow good drug manufacturing requirements that apply to commercial drug manufacturers. Compounding pharmacies custom-mix these products according to a health care professional's order. The mix contains not only the active hormone, but other inactive ingredients that help hold a pill together or give a cream, lotion, or gel its form and thickness so that it can be applied to the body. It is unknown whether these mixtures, which are not FDA-approved, are properly absorbed or provide the appropriate levels of hormones needed in the body. It is also unknown whether the amount of drug delivered is consistent from pill to pill or each time a cream or gel is applied.

Myth: "Bio-identical" hormone products can prevent or cure heart disease, Alzheimer's disease, and breast cancer.

Fact: Compounded "BHRT" drugs have not been shown to prevent or cure any of these diseases. In fact, like FDA-approved MHT drugs, they may increase the risk of heart disease, breast cancer, and dementia in some women. (See www.nhlbi.nih.gov/whi/index.html for information on the Women's Health Initiative, a large, long-term study that tested the effects of FDA-approved MHT drugs.) No large, long-term study has been done to determine the adverse effects of "bio-identical" hormones.

Myth: "Bio-identical" hormone products that contain estriol, a weak form of estrogen, are safer than FDA-approved estrogen products.

Fact: FDA has not approved any drug containing estriol. The safety and effectiveness of estriol are unknown. "No data have been submitted to FDA that demonstrate that estriol is safe and effective," according to Daniel Shames, M.D., a senior official in the FDA office that oversees reproductive products.

Myth: If "bio-identical" products were unsafe, there would be a lot of reports of bad side effects.

Fact: "Bio-identical" products are typically compounded in pharmacies. "Unlike commercial drug manufacturers, pharmacies aren't required to report adverse events associated with compounded drugs," says Steve Silverman, Assistant Director of the Office of Compliance in FDA's Center for Drug Evaluation and Research. "Also, while some health risks associated with 'BHRT' drugs may arise after a relatively short period of use, others may not occur for many years. One of the big problems is that we just don't know what risks are associated with these so-called 'bio-identicals.'"

Myth: A pharmacy can make a "BHRT" drug just for you based on hormone levels in a saliva sample.

Fact: "Advertisements that a drug can be created 'just for you' based on saliva testing are appealing," says Uhl, "but unrealistic." Hormone levels in saliva do not accurately reflect the amount of hormones a woman has in her body for the purpose of adjusting hormone therapy dose levels. A woman's hormone levels change throughout the day, and from day to day. FDA-approved tests can tell a woman's hormone level in a specific body fluid, such as saliva, blood, or urine, at that particular point in time. "These tests are useful to tell if a woman is menopausal or not," says Uhl, "but they have not been shown to be useful for adjusting hormone therapy dosages."

Myth: FDA wants all compounded hormone therapies off the market.

Fact: "We are not trying to pull all compounded hormone therapies off the market," says Silverman. "We believe that, like all traditionally compounded drugs, a woman should be able to get a compounded hormone therapy drug when her physician decides that it will best serve her specific medical needs. But we also want women to be informed and careful about choosing products that have not been proven safe and effective. And pharmacies cannot promote compounded drugs with false or misleading claims."

In addition, FDA has not approved any drug containing the hormone estriol. Pharmacies should not compound drugs containing estriol unless the prescriber has a valid investigational new drug (IND) application. INDs provide benefits that include allowing physicians to treat individual patients with drugs that are not FDA-approved, while also providing additional safeguards for patients.

Myth: All women who take FDA-approved MHT drugs are going to get blood clots, heart attacks, strokes, breast cancer, or gall bladder disease.

Fact: Like all medicines, hormone therapy has risks and benefits. For some women, hormone therapy may increase their chances of getting these conditions. However, there are no convincing data that there is less risk of developing a blood clot, heart attack, stroke, breast cancer, or gall bladder disease with a "BHRT" product. Women should talk to their health care professional about taking hormones. If you decide to use MHT drugs for menopause

  • use at the lowest dose that helps
  • use for the shortest time needed

If you are taking a compounded "BHRT" drug now, talk to your health care professional about treatment options to determine if compounded drugs are the best option for your particular medical needs.

This article appears on FDA's Consumer Updates page, which features the latest on all FDA-regulated products.

Updated: April 8, 2008

Here's a bit from the Wikipedia entry on BHRT (note that I didn't include Wikipedia's extensive hyperlinking - if you want to follow the hyperlinks, or follow the references to the original sources, visit the Wikipedia article).

Peer-reviewed assessments of the evidence for and against BHRT point to a lack of consensus, stemming from a dearth of randomized controlled trials. A 2006 literature review concluded that BHRT is "well tolerated, provides symptom relief, and can address many of the health needs as well as the individual preferences of menopausal and perimenopausal women" [1]. A subsequent review (2009) assessed 200 studies and concluded that there was evidence to suggest bioidentical hormones were safer and more effective than synthetic hormones.[9] It should be noted, however, that while both reviews appeared in peer-reviewed journals, the authors are prominent advocates of BHRT, with potential conflicts of interest. The author of the first review, Deborah Moskowitz, has been associated with a manufacturer of bioidentical hormone preparations [2], while the author of the second is Dr. Kent Holtorf (bio) a prominent natural/bioidentical hormone advocate.

Another 2008 review concluded that there was little evidence to support the use of compounded hormone products based upon saliva testing, and that individualized compounded hormone products have no proven advantage over conventional hormone therapies.

Here's an excerpt from an article by the Mayo Clinic.

There's a lot of interest in bioidentical — or so-called "natural" — hormone therapy for menopause symptoms. However, there's no evidence that bioidentical hormones are safer or more effective than standard hormone replacement therapy.

Here's a bit more from the same page, just a little further down.

According to the North American Menopause Society (NAMS), custom compounds may provide certain benefits, such as individualized doses and mixtures of products and forms that aren't available commercially. However, they may also pose risks to consumers. These compounds haven't been approved by the Food and Drug Administration (FDA) and as a result haven't been tested for purity, potency, efficacy or safety. These products may even contain unknown contaminants. For this reason, NAMS does not recommend these custom-mixed products over well-tested, government-approved commercial products for the majority of women.

Here are a few paragraphs from an article from a Harvard Women's Health Watch newsletter.

Many women assume that “natural” hormones would be better or safer — but the term “natural” is open to interpretation.

Any product whose principal ingredient has an animal, plant, or mineral source is technically natural. It doesn’t matter whether the substance is ground, put into capsules, and sold over the counter — or extracted in a laboratory, manufactured by a pharmaceutical company, and made available only by prescription. For example, the soy plant is the source of supplements that some women take to ease menopausal symptoms; it’s also used, along with yams, to make the estrogen in the FDA-approved hormone drug Estrace.

But unlike Estrace, soy supplements aren’t regulated and haven’t been rigorously tested in humans, so we don’t know whether they’re safe or effective. There’s some evidence that certain soy components may actually stimulate breast tumor growth. So “natural” doesn’t necessarily equal “safe” — and may simply be a euphemism for “unregulated.”

Here's more from the same page.

Are bioidenticals safer? No one knows. Studies have shown they can help relieve hot flashes and vaginal dryness, but as yet, few large studies have investigated the differences among the various hormones and methods of administration. More research is needed to further understand these differences and compare the risks and benefits.

Women taking bioidentical estrogen who have a uterus must still take an FDA-approved progestin or micronized progesterone to prevent endometrial cancer. So-called natural, plant-derived progesterone creams sold over the counter contain too little of the hormone to be effective. And yam extract creams don’t help because your body cannot convert them into progesterone.

Here's even more from the same page.

Much of the confusion about bioidentical hormones comes from the mistaken notion that they must be custom-mixed at a compounding pharmacy. But custom compounding is necessary only when a clinician wants to prescribe hormones in combinations, doses, or preparations (such as lozenges or suppositories) not routinely available — or to order hormones not approved for women, such as testosterone and DHEA. Compounding pharmacies use some of the same ingredients that are made into FDA-approved products, but their products are not FDA-approved or regulated.

One size doesn’t fit all in women’s health. Compounded hormones can certainly help to individualize treatment, but if you’re considering them, be aware of the following:

  • Compounded drugs are mixed to order, so there are no tests of their safety, effectiveness, or dosing consistency.
  • There is no proof that compounded hormones have fewer side effects or are more effective than FDA-approved hormone preparations.
  • Some clinicians who prescribe compounded hormones order saliva tests to monitor hormone levels. Most experts say these tests are of little use because there’s no evidence that hormone levels in saliva correlate with response to treatment in postmenopausal women.
  • There is no scientific evidence that the compounded preparations Biest and Triest, which are largely estriol, are safer or more effective than other bioidentical and FDA-approved formulations. Some proponents claim that estriol decreases breast cancer risk and doesn’t increase endometrial cancer risk. Both claims are unproven.
  • Heath insurers don’t always cover compounded drugs.

This doesn’t mean that you shouldn’t consider compounded hormones. Just realize that, in a real sense, you’re going to be an experiment of one. Unless your clinician has considerable experience with bioidentical hormones and a particular compounding pharmacy, you’re better off with a prescription for commercially available hormones, many of which are bioidentical.

And finally, here's the conclusion from that page.

The risk of any hormonal product depends on more than how the hormone is made. That’s why it’s important to work closely with a clinician to decide what’s right for you. If your symptoms are bothersome, discuss your options with a physician or other specialist in menopausal health. To learn more about menopause and bioidentical hormones, visit the Web sites of the Association of Women for the Advancement of Research and Education Project (Project Aware), www.project-aware.org, and the National Women’s Health Information Center, www.4woman.org/menopause.

One of the odd claims I found repeated numerous times in sources promoting BHRT is that bioidentical hormones aren't profitable for drug companies because they're not patentable. Here's an example of such a claim.

This occurs primarily because studies are usually funded by pharmaceutical manufacturers, who profit by selling patented synthetic hormones. Bio-identical hormones, which are chemically identical to hormones produced naturally in the human body, are not patentable.

This claim is easily put to rest by examining just how many commercially available hormones are bio-identical (see Wikipedia). There's Estrace, Alora, Climara, Esclim, Estraderm, Vivelle, and many others. Obviously, these manufacturers are finding a way to make a profit off of bio-identical hormones. To tell the truth, I'm not sure if bio-identical hormones can't actually be patented. To look at another chemical in our body, genes can certainly be patented. So, there's no barrier to patenting hormones just because they're part of our body. But I guess it depends on which hormones specifically you're talking about, and whether their chemical structures are already in the public domain.

It's a bit silly to claim that manufacturers can only make a profit off of a patentable item. For one thing, manufacturing processes and uses can sometimes be patented even when the item itself isn't patentable. A patent on a manufacturing process could be enough to eliminate competition for a bioidentical hormone if it was the most economical way to produce it. For another, we buy non-patentable products every day, and those manufacturers are certainly profiting by it. Just looking at my desk as I'm typing this, I have a mug, pens, pencils, paper, index cards, binders, bolts, paper clips, etc. Patented items are obviously not the only items that manufacturers sell.

Anyway, like I already said, the data's not there yet to support claims that BHRT is safer than conventional HRT, and in fact it appears to carry similar risks. Whether or not the risk of HRT is worth it is up to the individual patient, but patients definitely shouldn't be buying into the claims of BHRT proponents and assuming that BHRT is safer.

Website Update - Top 10 Page List Updated for June, July & August

Top 10 ListWell, the summer's over. I slacked off on this site for those months, and it definitely showed in my traffic. July was my worst site for visitors since 2007 when I started keeping track of how many people were only visiting my site to download a certain mp3. Traffic was down to 70.1% of what it was during my best month. I've started to get back into blogging again, and it appears that the downward spiral has finally bottomed out. August picked up, and was back to 74.4% of my best month. I'll try to keep putting out at least one good blog entry per week, and I'll see if my traffic picks back up to what it had been.

As normal, most of my popular pages remained popular. A couple new blog entries have found their way into the top 10 list - Response to E-mail Forward of Tea Party Speech and Running AutoCAD R14 in XP Pro 64. It's not really much of a surprise to see something political garner so many hits, but it's definitely nice to see the AutoCAD entry being so useful.

Considering that there's no real content in it or its comments, I still think that the entry, A Few Comments, is probably being visited mainly by spam bots (unless people are just really interested in Ray Comfort).

June List

  1. Autogyro History & Theory
  2. Blog - A Few Comments
  3. Blog - A Skeptical Look at MBT Shoes
  4. Factoids Debunked & Verified
  5. Programming
  6. Blog - Letter to Pharmacy about MBT Shoes
  7. Factoids Debunked & Verified, Part II
  8. X-Plane as an Engineering Tool
  10. Theoretical Max Propeller Efficiency

July List

  1. Autogyro History & Theory
  2. Blog - A Skeptical Look at MBT Shoes
  3. Blog - A Few Comments
  4. Blog - Running AutoCAD R14 in XP Pro 64
  5. Factoids Debunked & Verified
  6. Blog - Letter to Pharmacy about MBT Shoes
  7. Programming
  8. X-Plane as an Engineering Tool
  9. Factoids Debunked & Verified, Part II
  10. Blog - My Favorite Airplanes

August List

  1. Autogyro History & Theory
  2. Blog - A Skeptical Look at MBT Shoes
  3. Factoids Debunked & Verified
  4. Factoids Debunked & Verified, Part II
  5. Blog - Running AutoCAD R14 in XP Pro 64
  6. Blog - A Few Comments
  7. Blog - Letter to Pharmacy about MBT Shoes
  8. X-Plane as an Engineering Tool
  9. Programming
  10. Blog - Response to E-mail Forward of Tea Party Speech

Tuesday, September 8, 2009

Balanced Views

As with most of my recent blog entries, this started as an e-mail response to a friend, and has been adapted for use here.

Libra ScalesLooking to alternate viewpoints to get a balanced view of things is something we should all strive to do. If you only ever visit forums where everyone agrees with each other, those forums become echo chambers, and nobody ever examines their views. On the opposite end of the spectrum, though, just how do you determine who's worth listening to when there are so many voices and not all views are equally valid?

Strictly logically speaking, it makes no difference who's making an argument. It's the arguments themselves that need to be addressed to determine whether they're true or not. If you hang around the Internet long enough, you're bound to see people using the term ad hominem to criticize arguments against the messenger that ignore the message. Practically speaking, though, there's no way to read every point out there. In the age of the Internet, everybody with a computer can broadcast their opinions to the entire world. And with hundreds of channels on the satellite, even TV doesn't have the same respectability as it once did. At what point can you say that a certain source is no longer trustworthy, and no longer worth spending your time reading what they have to say? When the boy keeps crying wolf, at what point do you quit paying attention?

Are there any sources so outlandish you can just ignore them altogether? For example, in arguments over science curricula, I could point you to an organization that honestly and truly believes the world is flat. They've got quite a website with discussion forums to support their claim. But are they even worth taking a first look? It's very, very well documented that the world is roughly spherical. Can't we just call those people cranks without worrying about examining both sides of the flat earth issue?

A 'culture war' I've gotten more caught up in myself is evolution/geology/astronomy (and I guess you could throw physics in there too for radioactive decay & the speed of light) vs. creationism. I'd always accepted the science, but wondered if I might have been missing something when I first learned just how many people in this country doubted evolution and an ancient universe (this was around the time that Intelligent Design began making headlines a few years ago). So, I looked into the claims made by groups like Answers in Genesis, the Discovery Institute, the Institute for Creation Research, or individuals like Kent Hovind or Ray Comfort, and at the same time looked a little more into how science works and how we know what we know. The end result, as could probably be expected, is that the evidence for evolution and an ancient universe is overwhelming, and all those anti-science groups had used a lot of poor arguments (and even some dishonesty) to support their cause. But, they continue writing new essays and books, coming up with more arguments, and even making movies to support their claims. Am I still obligated to read what they have to say? Is it wrong to dismiss their new arguments out of hand because I've already seen how poorly they've performed in the past? Is it close minded to not want to waste any more of my time with them?

I guess what I'm getting at is the issue of credibility. Of course, we should always be skeptical of every source, never completely trust any single one, and always seek verification from other independent sources. Some sources are credible enough, however, that you can be pretty confident in the information from them until you see conflicting information from another source, while other sources are so lacking in credibility that you shouldn't accept anything from them until you've seen it elsewhere. Dictionaries and encyclopedias would fall into the former category. They're bound to have a few errors, but the entire editorial process guarantees that they're pretty darned accurate. E-mail forwards and tabloids definitely fall into the latter category. Other sources fall some where in between, so we have to determine how much trust we have in those sources.

Credibility isn't just about honesty. I'm sure the flat earthers I mentioned above are sincere in their claims and don't think they're lying. But they're still completely wrong, none the less. So, credibility has as much to do with competence as it does with sincerity.

One of the things that I'm really big on is science. I think it's the best method we have for answering questions that have objective answers, or in other words, the best method we have for determining reality. Some questions are beyond science. For example, gun control comes down to a question of personal freedom vs. societal safety. It's a question of how much value we place on those two aspects. Science can't give us those values. It can certainly provide statistics, telling us how many people a year are killed by guns or comparing safety in nations with gun control laws to those without. So, we can use science to help inform our opinion, but we can't use it to make the final decisions on legislation.

Most people don't understand science very well, but for most of those people, you just have to let it slide or you'd be arguing all the time, and I'd rather just enjoy their company (as I've pointed out before, 1 in 4 Americans thinks the Sun goes around the Earth, and over half don't realize electrons are smaller than atoms). But, once people are in a position of public prominence, where their voice is heard by a large number of people, they have a responsibility to make sure their voice is accurate. And that means either having a very good grip on science themselves, or, less preferably, knowing where to go to get the results from science.

This is especially true for politicians. They make the laws that affect all of us, so they need to make sure that their laws are based in reality. And they deal with a large range of issues, so they need to know how to determine the best sources even when the issue is outside their immediate field of expertise. When politicians get the science wrong, it really makes me question their credibility. It means either that they're ignorant, or that they're willing to put their ideology ahead of the evidence (or, hopefully much less common, that they're willing to lie to pander to their constituents).

One of the most obvious examples of this is global warming. The evidence for global warming is very strong, and the vast majority of experts in the relevant fields are confident in the science. When I see politicians or other public figures claim that global warming isn't happening, or saying that the science isn't all that certain, it makes me question everything else they say. Another example, not quite so prevalent yet, but getting bigger, is the anti-vaccination movement, or the whole alternative medicine movement in general. Medicine now is the best it's ever been in history, thanks almost entirely to evidence based practices and the double blind clinical trial. Vaccines have saved millions. People who are willing to ignore that put their lives at risk, and in the case of the anti-vaccination movement, put other's lives at risk because of reduced herd immunity. So, the global warming denialists, anti-vaccinationists, alternative medicine proponents, or anyone else who gets science egregiously wrong, also make me question everything else that they say, because it shows that they're too ignorant to understand the evidence or are willing to ignore that evidence when it suits their agenda.

Everything I've said so far has been pretty neutral on politics - just general statements. But I'll be honest - in the past decade or so since I've been more actively following politics, it seems that Republicans are worse off in the credibility department than Democrats (i.e. The Republican War on Science). It's certainly not an all or nothing dichotomy, as there are plenty of Democrats I wouldn't trust as far as I could throw, and plenty of crazy ideas seem to be more associated with the left (9/11 conspiracy theories, alternative medicine), but as the comedian Stephen Colbert often says, it seems that "Reality has a well known liberal bias." Maybe my perception is due to sampling bias because I receive far more erroneous e-mail forwards that support Republicans than those supporting Democrats. Maybe it's because the Republicans have been in power, so they've been critiqued a bit closer, and maybe I'll start to see more of it coming from the left now that they're in power. Maybe it was the Bush administration in particular that abused science, and it isn't such a general trait for all Republicans. Maybe the official platform of the Texas GOP isn't actually representative of most Texas Republicans or indicative of Republicans in other states. But you don't often hear of Democratic school board members introducing anti-evolution measures. And the amount of Republican politicians who refuse to make a simple comment on Obama's citizenship, or who fanned the flames of this death panel nonsense and spread other misinformation over the health care debate, doesn't help with their credibility, either.

I thought of not including that previous paragraph so that this entry would remain politically neutral, but that's honestly how I see it, and I figured that it would help others to see partly why I have the views I do. I realize that politicians from both sides of the aisle will lie to win votes, but my impression is that there's far more misinformation from the right side than the left. But, that's also why I appreciate the conservative e-mails that friends send me, and hope that they keep sending me. It keeps me from only seeing one side of things.

Anyway, I apologize for rambling a bit with this entry. Looking to alternate viewpoints to get a balanced view of things is a noble goal. The problem is that there's just not enough time to listen to everybody's point of view, so it becomes a challenge of figuring out who's credible enough to listen to in the first place.

Updated 2009-09-09 - Removed a section describing my own views on gun control, since it doesn't add at all to the theme of this entry.

Wednesday, September 2, 2009

Response to an E-Mail Supposedly Summarizing Dr. Charles Krauthammer's Views on Obama

ObamaWell, I got another e-mail that I couldn't help but respond to, and that I figured was worth publishing my response on this blog. I don't mean to makethis blog too political (there are a lot of other things I like much more than politics), but recycling e-mails is an easy way to come up with blog entries.

Anyway, like normal for these things, I've formatted the entry to put the original e-mail in blockquotes, followed by my responses (edited just a bit from the e-mail version). My responses are not meant to be a complete point by point refutation of the e-mail, but only cover the most outrageous statements.

Krauthammer's Views on President Barack Obama

Dr. Krauthammer is on Fox News. He is an M.D. and he is paralyzed from the neck down. Be forewarned on what is happening. A friend went to hear Charles Krauthammer. He listened with 25 others in closed room. What he says here, is NOT 2nd-hand, but 1st.

Last Monday was a profound evening, hearing Dr. Charles Krauthammer speak to the Center for the American Experiment. He is brilliant intellectual, seasoned and articulate. He is forthright and careful in his analysis, and never resorts to emotions or personal insults. He is NOT a fear monger nor an extremist in his comments and views. He is a fiscal conservative, and has a Pulitzer Prize for writing. He is a frequent contributor to Fox News and writes weekly for the Washington Post. The entire room was held spellbound during his talk. I have shared this with many of you and several have asked me to summarize his comments, as we are living in uncharted waters economically and internationally.

According to Krauthammer himself, this is not an accurate representation of his talk. Remember not to trust anything in an e-mail until you've seen independent confirmation somewhere else.

The authorship says nothing about the validity of the claims. However, realize that it means that these are just the thoughts of somebody with an e-mail account, not those of somebody with the credentials of Krauthammer.

1. Mr. Obama is a very intellectual, charming individual. He is not to be underestimated. He is a cool customer who doesn't show his emotions. It's very hard to know what's behind the mask. Taking down the Clinton dynasty from a political neophyte was an amazing accomplishment. The Clintons still do not understand what hit them. Obama was in the perfect place at the perfect time.

Nothing to refute, since it's just claiming that Obama is a good politician.

2. Obama has political skills comparable to Reagan and Clinton. He has a way of making you think he's on your side, agreeing with your position, while doing the opposite. Pay no attention to what he SAYS; rather, watch what he DOES!

Nothing to refute here, either. It's simply saying that, as with all politicians, pay attention to their actions, not their campaign promises.

3. Obama has a ruthless quest for power. He did not come to Washington to make something out of himself, but rather to change everything, including dismantling capitalism. He can’t be straightforward on his ambitions, as the public would not go along. He has a heavy hand, and wants to level the playing field with income redistribution and punishment to the achievers of society. He would like to model the USA to Great Britain or Canada .

Seems a bit hyperbolic, don't you think? A bit inconsistent, too, claiming Obama wants to dismantle capitalism, while at the same time claiming Obama wants to model the US after the UK and Canada, both of which are capitalist.

As far as leveling the playing field, yes Democrats do favor a bit more redistribution than Republicans. I tend to agree with some redistribution which I've already explained previously. I have to admit to benefiting from that redistribution myself, since I took advantage of government scholarships to help pay for my college (actually, I know very few people who went to college without some sort of financial aid from the government).

4. His three main goals are to control ENERGY, PUBLIC EDUCATION, AND NATIONAL HEALTH CARE by the Federal government. He doesn't care about the auto or financial services industries, but got them as an early bonus. The cap and trade will add costs to everything and stifle growth. Paying for FREE college education is his goal. Most scary is his healthcare program, because if you make it FREE and add 46,000,000 people to a Medicare-type single-payer system, the costs will go through the roof.. The only way to control costs is with massive RATIONING of services, like in Canada . God forbid.

As I've said many times, economics isn't my strong point. I'm sure a carbon cap and trade system will raise prices somewhat, but how else do we pay for the development of technologies to reduce greenhouse gas emissions? Even if Krauthammer or the author of this e-mail have a different proposal than a cap and trade system, the money for that development has to come from somewhere, which ultimately means from us, either in higher taxes or higher prices on goods.

Is a free college education really that bad of a thing? Does the author think higher education should be reserved only for those that can afford it?

As far as health care, I'm getting a bit sick of hearing people only refer to Canada or the UK when complaining about universal health care (and stretching the truth when referring to those two countries, as well). Why doesn't anyone ever talk of the Netherlands, France, or Spain? On this blog, I've already referred previously to a good article comparing health care in the U.S. to the rest of the industrialized world. Here it is again.

Here's another link, this one from the World Health Organization. In 2000, it ranked the U.S. health care system 37th in the world.

As far as the rationing comment, the only way to control costs of any health care system with finite resources is through some sort of rationing, which is currently being done in the U.S. primarily by the private insurance companies. In the real world, where we don't have unlimited money to spend, some amount of rationing has to be done, no matter how much we may dislike it.

I've written a bit more on the health care issue here.

5. He has surrounded himself with mostly far-left academic types. No one around him has ever even run a candy store. But they are going to try and run the auto, financial, banking and other industries. This obviously can’t work in the long run. Obama is not a socialist; rather he's a far-left secular progressive bent on nothing short of revolution. He ran as a moderate, but will govern from the hard left. Again, watch what he does, not what he says.

This author really thinks Obama has surrounded himself with the far left? The main complaint I've seen on more liberal sites is that Obama is too far right. He's made a point to include many moderates and even Republicans in his appointments.

I think the words that this author used perjoratively are interesting. For example, 'far left academic types'. Is he implying that educated and liberal are the same thing? Does he have a problem specifically with educated people? The other interesting term was 'secular progressive'. What's wrong with secular politicians? We have a secular government. Most activities we perform are secular. Does this author want a theocracy?

And what's with the hyperbole with 'revolution'?

6. Obama doesn’t really see himself as President of the United States , but more as a ruler over the world. He sees himself above it all, trying to orchestrate and coordinate various countries and their agendas. He sees moral equivalency in all cultures. His apology tour in Germany and England was a prime example of how he sees America , as an imperialist nation that has been arrogant, rather than a great noble nation that has at times made errors. This is the first President ever who has chastised our allies and appeased our enemies!

This isn't even consistent. Obama supposedly sees himself as ruler of the world, yet travels the world apologizing for our mistakes? And why do people consider it unpatriotic to own up to mistakes?

7. He is now handing out goodies. He hopes that the bill (and pain) will not come due until after he is re-elected in 2012. He would like to blame all problems on Bush from the past, and hopefully his successor in the future. He has a huge ego, and Mr. Krauthammer believes he is a narcissist.

Not enough of substance here to refute.

8. Republicans are in the wilderness for a while, but will emerge strong. We're pining for another Reagan, but there will never be another like him. Krauthammer believes Mitt Romney, Tim Pawlenty and Bobby Jindahl (except for his terrible speech in February) are the future of the party. Newt Gingrich is brilliant, but has baggage. Sarah Palin is sincere and intelligent, but needs to really be seriously boning up on facts and info if she is to be a serious candidate in the future. We need to return to the party of lower taxes, smaller government, personal responsibility, strong national defense, and state’s rights.

Not really much to comment on here, since it's a statement of subjective preferences. The only thing is that I would prefer to see 'fiscal responsibility' rather than 'lower taxes.' When the government has to increase spending, the only responsible thing to do is pay for it. And I'll skip commenting on the quality of those particular people (except 'death panel', 'global warming isn't real' Palin - I still can't believe she was a candidate for VP).

9. The current level of spending is irresponsible and outrageous. We are spending trillions that we don’t have. This could lead to hyper-inflation, depression or worse. No country has ever spent themselves into prosperity. The media is giving Obama, Reid and Pelosi a pass because they love their agenda. But eventually the bill will come due and people will realize the huge bail outs didn’t work, nor will the stimulus package.

These were trillion-dollar payoffs to Obama’s allies, unions and the Congress to placate the left, so he can get support for #4 above.

I know this e-mail is about Obama, but how can Republicans claim the high ground on fiscal responsibility? With Reagan and Bush senior, the national deficit increased. We had a brief respite and a budget surplus under Clinton. Then, after 6 years of Republican controlled House, Senate, and executive, we had huge deficits. Yes, we were fighting a war under Bush Jr., but how can you justify lowering taxes when you know there's going to be increased spending?

As far as the recession, the current consensus among economists is that it seems to be getting better. I realize people will argue over the cause until the cows come home, but I think a fair case can be made for the government's intervention actually helping. At any rate, if the consensus is correct, it certainly puts to rest the claims that the current policies are only going to make matters worse.

10. The election was over in mid-September when Lehman brothers failed, fear and panic swept in, we had an unpopular President, and the war was grinding on indefinitely without a clear outcome. The people are in pain, and the mantra of change caused people to act emotionally. Any Dem would have won this election; it was surprising it was as close as it was.

I agree that the war and the economic crisis pretty much did guarantee that the Democrats would win the presidential election. But this author's surpised it was so close? Obama had the largest percentage of the popular vote in decades - the largest by the non-incumbent party since FDR.

11. In 2012, if the unemployment rate is over 10%, Republicans will be swept back into power. If it's under 8%, the Dems continue to roll. If it's between 8-10%, it will be a dogfight. It will all be about the economy. I hope this gets you really thinking about what's happening in Washington and Congress. There is a left-wing revolution going on, according to Krauthammer, and he encourages us to keep the faith and join the loyal resistance. The work will be hard, but we're right on most issues and can reclaim our country, before it's far too late.

Well, we'll just have to wait and see what happens in 3 years.

Anyway, I apologize for the recent glut of politcal entries, but I have to confess that I have a few more in the works right now. I probably wouldn't write so many, though, if politics wasn't so full of people claiming things that weren't true. Hopefully I can get this all out of my system and get back to writing about less controversial topics, like evolution and religion.

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