The MacDoctor sees that the Lancet is up to its old tricks again – publishing controversial comments and papers with poor scientific reasoning behind them. You would have thought that almost single-handedly producing the anti-vaccine movement with a poorly researched, bogus article would have taught them some caution, but apparently not.
Not yet published in print, but available online, there is this commentary: Britt K, Short R. The plight of nuns: hazards of nulliparity Lancet online DOI:10.1016/S0140- 6736(11)61746-7. It is subscription only but here is the main premise:
“The Catholic Church condemns all forms of contraception except abstinence, as outlined by Pope Paul VI in Humanae Vitae in 1968.13 Although Humanae Vitae never mentions nuns, they should be free to use the contraceptive pill to protect against the hazards of nulliparity since the document states that “the Church in no way regards as unlawful therapeutic means considered necessary to cure organic diseases, even though they also have a contraceptive effect”. If the Catholic Church could make the oral contraceptive pill freely available to all its nuns, it would reduce the risk of those accursed pests, cancer of the ovary and uterus, and give nuns’ plight the recognition it deserves.”
The argument in a nutshell is based on the well-attested fact that nulliparity (not having any children) increases your overall risk of breast, uterine and ovarian cancer. The combined oral contraceptive pill has some protective effect against the latter two. Therefore nuns should be allowed to take the pill to protect them from cancer.
This argument falls in a number of areas. Firstly, in the graph that the authors publish to “prove” their point (shown below), it can be seen that nuns are only at risk from increased rates of uterine and ovarian cancer in their 80s. As these two cancers are rare diseases anyway, it would seem that their relative risk of dying from these diseases is still likely to be very small. There is an appreciable risk from the far more common breast cancer, but the oral contraceptive has not been shown to protect against breast cancer and may, in fact, increase the risk slightly.
Secondly, these graphs make no effort to determine the other risks of the pill relative to nuns, notably thromboembolism (clots in the legs and the lungs) and high blood pressure. We know that the pill reduces mortality for women overall, but that is because taking the pill is much safer than having babies. This factor is not a consideration for nuns. It may well be (in fact I would consider it likely) that the risks of the oral contraceptive will outweigh any gains. Particularly as the authors are essentially proposing that nuns take the pill continually, unlike most women. We have no idea whether this imposes additional risks to the taker.
Finally, the fact is that nuns live, on average, 5 years longer than women in general (I do not recollect the name of the paper I saw this in, but the study involved 70+ thousand nuns and seems quite robust). This is probably due to a number of factors such as reduced stress, reduced likelihood of accident and healthier lifestyles. Their choice to dedicate their lives wholly to God does them no harm and provides them with long, often very healthy lives. It is absurd to take a single aspect of an otherwise healthy lifestyle and blow in out of all proportion. Indeed, it seems that the only purpose of the authors is to castigate the Pope for his decree against contraception because there appears to be no valid medical or clinical purpose evident. This kind of nonsense is best left to the tabloids and does not belong in a reputable medical journal.
The MacDoctor sees Hone Harawira is up to his old tricks, giving his customized oath while walking the centre of the chamber to swear the legitimate one. It is like watching a little child testing the boundaries of its parents “Look at me daddy, I’m not really crossing the line, just putting my toecap across it…”
Lockwood Smith should probably give him a good smack – except we can’t do that in New Zealand can we?
The Greens also want to protest the oath but are using a little more decorum and acting somewhat like adults.
No one seems to have observed the most obvious thing about the matter of the MPs oath. You swear allegiance to the Queen because you are still part of her empire. It is not possible to change the oath (so that you swear allegiance to New Zealand) unless we first decide to become a republic.
The debate we need to have is therefore whether we want to break our ties with the non-existant British Empire and become a republic, NOT whether we want a new MPs oath. Our MPs should stop grandstanding on this issue and put up a serious bill proposing that New Zealand becomes a republic.
The MacDoctor has no particular axe to grind either way, with the sole proviso that, should we decide to become a republic, we should first put together a written constitution. The US constitution is an excellent place to start, though I would imagine we would probably baulk at some of the amendments.
Dear Mr. McCarten
You seem to be a bit up yourself, lately.
Your column in the Herald on Sunday absurdly compares the recent life-threatening, regime-changing protests overseas with the history of New Zealand left-wing protests. You even manage to include an entirely prospective protest against “asset sales”. Aside from the fact that this comparison is rather insulting to those who have risked life and limb opposing oppressive regimes, you seemed to have overlooked the fact that the vast majority of recent protests have been against unelected undemocratic regimes – excluding the rather ridiculous “occupy” movement which appears to have no real purpose at all. This particular point is at the heart of asset sales.
Firstly, let me point out that the term “asset sales” is somewhat disingenuous. Assets are not actually being sold are they? What is being sold is the minority part of the government’s shareholding in certain SEOs. It is not possible for “John Key’s rich overseas mates” (not your words, but some from our friends at the Standard) to gain a controlling interest in these companies. In addition, the government has only about a 75% shareholding in Air New Zealand so it is very difficult to envisage that somehow a 51% shareholding is intrinsically bad, isn’t it?
Secondly, you quote the bogus statistic that “Two out of three New Zealanders” oppose asset sales. This is nonsense. You base this disinformation of a couple of ad-hoc polls run by two partisan newspapers – which asked the bald question “do you oppose asset sales” in a climate where Labour had just spent months instilling fear into the population about another possible fire-sale of assets à la the last Labour one. The fact that you cannot see that this makes the results of said polls utterly unreliable speaks volumes about your own prejudices.
Lastly, you seem to think that protesting is some form of ad-hoc democracy. It certainly can be – if the protesters are a sizeable chunk of the population and all agree on the same solution. Ten percent of the population would be a reasonable rule of thumb for this sort of protest. Of course, you would attract the government’s attention with considerably less than 500,000 people, but we are talking about a protest that is part of democracy, not advocacy. In case you misunderstand this last point let me be clear. We have recently had elections. However much you may have disliked the result (and castigate the people who did not vote – as if they would have voted for Labour instead of National – go figure), there is no doubt that this was a proper democratic result. The people have stated that they prefer National’s package to Labour’s. National’s package includes asset sales as an integral part of their package. It is a little hard to believe, after many months of Labour campaigning on this, that people were unaware what they were voting for. Unlike you, I choose to believe that people voted rationally and that they were not confused about partial asset sales. That is, they democratically voted for these share sales.
So, Mr McCarten, by all means have your protests and make the point that you are unhappy about this. But let us not conflate this with a popular rising of the people. This will be a bunch of noisy activists pretending that their opinion is the right one – and that the recent democratic election of the current government was somehow a colossal mistake made by very, very stupid people. Do not be disappointed if we do not come and we do not care.
Seen on Stuff:
“An invasion of jellyfish has hit Wellington sparking warnings for people to be careful and to keep dogs out of the water.”
MacDoctor would like to suggest they check to see if the Beehive has sprung a leak…
Not that she ever left, but it seems that Paula Bennett has taken back Waitakere on the judicial recount by a margin of 9 votes. The MacDoctor realises that Ms. Bennett (when the media finally ask her opinion on the matter) will likely be far more gracious about her victory than Ms. Sepuloni.
However, the MacDoctor suspects she would like to do THIS:
Childish, I know, but soooo satisfying.
And Paula is indeed very gracious…
However, Labour insists on being distressingly unpleasant:
“Labour will seek advice from party scrutineers who watched the recount, said general secretary Chris Flatt.
“He said the party also wanted advice on whether Ms Bennett would be out of Parliament altogether and could not claim a list seat if the electorate result was overturned on an electoral petition.
“Electoral law specialist Graeme Edgeler believes that is the only way to interpret the Electoral Act which says a seat shall become vacant if on an electoral petition the High Court or Court of Appeal declares his or her election void.
“Removing such a critical minister in the National Government as Ms Bennett is likely to be a strong incentive for Labour.”
what you are behind closed doors will always eventually show up in public to embarrass you”
The MacDoctor has heard it said that what you do in your private life has no bearing on what you do in public. He clearly recalls that mantra being chanted loudly in the Clinton era but, though the voices have changed, the song remains the same even today.
He thinks this is a load of old hooey.
Take for example, the rather sad case of the Chinese GP, Hong Sheng Kong. He has defrauded the Auckland District Health Board of $183,134 (which he has admitted to). He may have defrauded the ADHB by as much as $1.3 million. He has such people as Dr. Jackie Blue and Raymond Huo providing character references for him and saying how much of a loss to the immediate chinese community it would be if he was struck off.
“Dr Blue told the Herald Kong was genuinely remorseful for his mistakes, he was a good doctor and he had the support of the Chinese community.”
The implication is that Dr Kong’s ability to practice good medicine is unaffected by his dishonesty. Dishonesty that is being described as “mistakes”. The MacDoctor finds it hard to see how $183,134 of fraudulent billing can be a “mistake”. He is completely flummoxed by the idea of $1.3 million in incorrect billing being a “mistake”.
The basic problem with this idea, that Dr Kong can be a dishonest biller but an honest doctor, is that it is not possible to compartmentalize life in such a fashion. Dr Kong provides us with a real life example:
“An elderly Chinese man had gone to see him with a right heel ulcer in 2005. His daughter asked that a biopsy be taken as she feared he had cancer.
“Kong was said to have refused and diagnosed diabetes. The man was diagnosed with melanoma four months later and died in 2007. Kong is alleged to have changed the records to say he offered a biopsy but it was refused.”
This is a classic “he said, she said” story. Normally, the MacDoctor would have lent more credence to the GPs story. Partly because patients often misremember a consultation several months after it happens, whereas the doctor makes (or should make) contemporaneous notes. Also it is unusual for a doctor to refuse to biopsy an ulcer, if there is any doubt at all as to its origin.
Unfortunately, you now have to contend with the fact that Dr. Kong is a proven liar who has altered patient records (bills) for his own benefit. You can see how this immediately slants the argument in favour of the patient’s daughter’s version of events.
Unethical behaviour in one part of your life always spills over to other areas. It does not matter if the unethical behaviour is seemingly unrelated to the area in question. Dr. X may be a good surgeon, but he is having an affair with his secretary – can you really trust him with any of his female patients? Are you happy to tell your GP your troubles with your boss, knowing that she is the town gossip (the GP, not your Boss)? Would you trust a paediatrician whose children all say she beat them with a hose when they were small? As a female patient, are you going to be comfortable knowing that your GP spends his evenings dressed in leather, watching BDSM pornography (The MacDoctor hastens to add, he has no leather or porn in his house – ok, ONE leather jacket, but THATS IT! Honestly, you people!)
In this day and age where, so often, celebrity replaces character and not getting caught is a substitute for doing right, we would do well to remember that what you are behind closed doors will always eventually show up in public to embarrass you. Nobody expects perfection – except for the terminally naive – but there are some character traits you just can’t fake. If you don’t have them everywhere in your life, you don’t have them anywhere.
It’s all one piece…
That was almost funny – but, naah, still got nothing.
Pretty much what the Labour Party still have…
The MacDoctor always knew that there would eventually be someone stupid enough to fall foul of Judith “Crusher” Collin’s boy-racer legislation. It has taken its time to come to this, but he is delighted that Ms. Collins will get her wish to witness the first car crushing as outgoing minister for corrections and crushings. MacDoctor would like, one again, to suggest she uses the above method and drives the tank herself. She deserves it. Think of it as a Christmas Gift.
Some people are not enthusiastic about this development:
“Clive Matthew-Wilson, road safety campaigner and editor of dogandlemon.com, said Forrest would now be seen as a hero by his mates. <snip>
““If the Government continues to crush a lot of boy racer cars, the boy racers will simply buy a cheap second car, one they can afford to lose when the police seize it.”
“Mr Matthew-Wilson said the legislation was mainly there to make politicians look tough on crime and he doubted it would make the slightest bit of difference to the average boy racer.”
Mr. Matthew-Wilson is, of course, dead wrong. There has already been an 18% reduction in boy-racer incidents since December 2009. Many areas that used to be terrorised at night are now quiet.
The MacDoctor also thinks Mr. Matthew-Wilson underestimates the attachment of boys to their cars. The special care and attention. The pimping and careful souping up. These are a boy racer’s pride and joy. They would probably prefer to go to jail.
As to second hand cheap cars, what boy is going to want to parade his sad jalopy in front of a crowd of his (slightly) more sensible mates who have retained their chargers? Methinks Mr. Matthew-Wilson underestimates the impact of the loss of a boy-racer’s raison d’être.
There may be a brief moment of glory on Facebook, but the depressing reality will soon set in that the “hero” is, in fact, merely a complete loser.
I see that Ms Mojo Mathers has made it into parliament on the Green list. She is profoundly deaf since birth. I have nothing but admiration for people with a significant disability who get on with life and achieve some measure of success.
I have also nothing but contempt for those who seem to think that deaf people are either stupid or not worth their time. Interacting with the deaf can certainly be a little more time-consuming. I know a GP who is profoundly deaf. She uses a special computerized stethoscope to listen to heart and lung sounds, which is probably considerably more accurate than the cheaper manual one. Referrals from her to the hospital I worked at were done via “relay” – a transcriber would type out my questions to her and she would answer. It worked perfectly well and was less time consuming than an interpreted call for patients who speak a foreign language.
There has been some silly comments in the blogosphere about what changes have to be made to accommodate Ms. Mathers, and how much they may cost. I suspect very little, as it should be simple to connect her directly to the Hansard as it is transcribed (I presume it is transcribed directly rather than simply recorded).
Be that as it may, the cost and possible inconvenience of this is utterly immaterial. However much I would probably disagree with Ms. Mathers politically, one thing is abundantly clear; Mojo Mathers is a human being whose opinion is worth listening to and who can make a worthwhile contribution to politics and to New Zealand. The trivial amount of time and money required to assist her in her communication needs is completely insignificant compared to this fact.