Opting Out

Some doctors don't want to assist the state in killing prisoners, and some pharmacists don't want to fill prescriptions they think will kill fetuses. Doctors, within limits, get to decide who they will treat — should pharmacists have that same right when it comes to filling prescriptions? Dahlia Lithwick says no.

The law recognizes that doctors' special relationship with their patients warrants a legal privilege: Their discussions are kept secret. You may like and trust your pharmacist. You may even trust him with intimate details about your yeast infection. But your pharmacist has neither the tools nor the right to probe details about rape and abuse, incest and health risks. Which is why pharmacists who interpose between decisions made by a doctor and her patient are overstepping not just moral but legal boundaries — and undermining another professional relationship that is fundamentally different from their own.

Dahlia Lithwick is right. But if we take this approach, do we need to consider the "law of unintended consequences" when it comes to staffing pharmacies? Leon Wolf at Red State says yes.

In other words, if you force the sole pharmacist in rural South Dakota to provide the morning after pill, that conscientiously objecting pharmacist is at least as likely to opt for early retirement or a move to more conscience hospitable climes than he/she is to just cast aside deep objections to the morning after pill. The result? NO pharmacist for everyone in that rural South Dakota town — including the woman who wants her morning after pill as well as the grandmother who wants her heart medications.

Leon Wolf is wrong. First, one would have to seriously question the moral conscience of his hypothetical "sole pharmacist in rural South Dakota" who would decide to pack up shop and deny lots of people their live-saving medicine because he or she doesn't want to fill a legal prescription for another drug. One would also have to quantify the risk of such a thing happening, something that Wolf doesn't attempt. It's easy to say "at least as likely"; it's harder to back that claim up, and he doesn't even try.

Second, basing heath-care policy on the playground ethic of "I'm taking my ball and going home if I don't get my way" is itself morally repugnant. If there is any area, anywhere and for any reason, that is without a means of delivering prescription drugs to patients, then the solution is to provide those services, either directly through the doctors' offices or via public clinics. If pharmacies are unwilling to meet the health-care needs of a community then other organizations need to step up to the plate. The unreliability of private pharmacies shouldn't be used to justify making private pharmacies even more unreliable.

But third, and most important, Wolf avoids the key question of where to draw the line when it comes to allowing pharmacists (or other professionals) to opt out of providing services on moral grounds. I've addressed this question before, and the answer seems clear — the line needs to be drawn in a way that mandates the fulfillment, without delay, of any legal prescription. Pharmacists don't have the credentials to be making these kinds of medical decisions for their customers, and they shouldn't be allowed to.

Work Sucks

I'm not speaking about my job specifically, but just work in general. However, it is my job specifically that has kept me away from this site for the past several days, and probably will for at least a few days more. By then, there will be a clean and shiny new website somewhere, and I can return to a less stressful mode.

Four Things

Chris Casey tagged me, so here we go:

Four jobs I’ve had:

1. Busboy, Fisherman Four Seafood Restaurant
2. Deputy Campaign Manager, Inez Tenenbaum for Lt. Governor
3. Internet Operations Director, DNC
4. Project Management Director, Plus Three

Four movies I can watch over and over:

1. Big Trouble in Little China
2. The Godfather
3. The Adventures of Buckaroo Banzai Across the 8th Dimension
4. China Town

Four places I’ve lived:

1. Charlotte, NC
2. Columbia, SC
3. Amherst, MA
4. Alexandria, VA

Four TV shows I love:

1. Lost
2. CSI: Miami
3. The Office
4. Everybody Hates Chris

Four places I’ve vacationed:

1. Amelia Island, FL
2. Cape Cod, MA
3. San Francisco
4. Disney World

Four of my favorite dishes:

1. Fried calimari
2. Buffalo wings
3. Blackened grouper
4. Anything on the menu at Galileo

Four sites I visit daily:

1. Atrios
2. Tapped
3. Washington Post
4. Slashdot

Four places I would rather be right now:

1. On the 17th at Sawgrass with a large bucket of balls
2. Walking on the beach on the Isle of Palms
3. Lounging on the sofa with the cat
4. Anywhere with Mary

Four bloggers I am tagging:

1. Chuq Yang
2. Jesse Berney
3. Scott Long
4. Oliver Willis

Dead-Eye Dick

Wow, it looks like it's already time for another independent counsel!

Poetic Justice

Of course, these accusations demand the immediate appointment of an independent counsel.

Sen. Pittenger's War on Science

In today's Charlotte Observer, Republican State Senator Robert Pittenger lends his efforts to his party's war on science by denying that human activity is a significant cause of global warming. As an example of its specious species, it's nothing special. But since Pittenger a member of the N.C. Legislative Commission on Global Climate Change (which I wrote about here), his wingnuttery actually has a public policy impact, so let's take a closer look at what he says.

Pittenger starts out by noting that there are natural warming and cooling cycles, and that human activity has very little additional impact.

A study by Jager and Barry from 1990 found that over the past 1 million years, there have been eight periods of glaciers and ice caps advancing and retreating — all of this occurring without automobile and power plant pollution from humans.

…While the Earth is currently warming, the real question that should be asked is, "Can we do anything about it?" The answer is very little, since this cycle was occurring prior to the first human civilizations.

This is nonsense. No one denies the existence of natural climate cycles, but the scientific consensus holds that human activity is the most significant factor in global warming. Indeed, Pittenger's punch line above about being able to do "very little" because there are natural factors at work begs the question of how important human activity is. He doesn't back up his assertion with scientific evidence because there isn't any that supports it.

Next, Pittenger bemoans the difficulty of climate science, and suggests that this complexity precludes us from making any reasonable predictions about the impacts of global warming.

While it is understood that human carbon emissions have a small effect on global climate, the computer models predicting global flooding and catastrophes rely on numerous variables that can greatly affect the long-term temperature change estimates, particularly particles, water vapor and clouds.

Particles, or aerosols, tend to have a cooling effect as solar energy is reflected back into space. Increased water vapor as a result of higher temperatures tends to enhance global warming if the lower atmosphere warms up, though satellite data has shown no such warming to date. Clouds can either cool or warm the climate depending on their composition and led the United Nations IPCC to state that "clouds represent a significant source of potential error in climate simulations."

Yes, climate models are not perfect, and no one seriously disputes that. But in the end the science here is stunningly clear: human-induced global warming will have dire consequences. To take an element of uncertainty acknowledged by the discipline and use that to undermine its overall validity is dishonest and not in keeping with the scientific method. Oh, and his claim about what the satellite data shows is completely false. In fact, the data actually lend quite a bit of support to contemporary climate models.

Pittenger concludes by claiming reducing carbon emissions would have a ruinous impact on our economy and hurt the world's poor.

These three variables combined make it extremely difficult to argue for significant carbon emission reductions, which will have enormous negative economic impact on developed and developing countries — all based on estimates for 100 years in the future.

The "negative impact" he mentions is asserted, never argued for, but I imagine he is thinking of the costs installing carbon dioxide scrubbers on smokestacks and the like. No doubt there would be costs associated with reducing emissions, but there are also costs to not acting, e.g. watching south Florida sink into the rising ocean. There are also the economic gains that the birth of a new environmental industry would generate, but Pittenger doesn't consider that side of the equation.

We must also consider the costs of diverting vital resources from important issues like feeding the world's poor and providing ample water supply to emerging countries, which is the most important factor to impact world health. Contrary to the wishful thinking of those who believe we can alter climate change, such an emphasis could adversely affect critical world issues. The billions and by some estimates even trillions that it would cost society to cut carbon emissions would have a minute effect on projected global climate change while diverting our resources from more important issues at hand.

How sad that the richest, most powerful nation on earth, which currently devotes a whopping 0.17% of its GDP on foreign aid, just can't afford to give any more. But seriously, foreign assistance is only a zero-sum game if our policy makers choose to make it one. In that case, the responsibility lies on those making that choice, and not those who are pushing the for more good to be done in the world.

In the end, reasonable people can agree on the scientific consensus and still disagree on what action needs to be taken — science doesn't overdetermine policy. But Pittenger doesn't get this. Instead of making his arguments based on the facts of the matter, he distorts the science, magnifies the uncertainties, and leaps to unsupported conclusions. Our future is not in good hands as long as people like Robert Pittenger are in charge.

Super Bowl Ads Revisited

Next to the awful officiating, the biggest story of this year's Super Bowl was, as usual, the commercials. So here's my list of the best and the worst of last night's ads.

• Best Hyped Ad: The Burger King musical extravaganza. The piling on at the end to make the Whopper, and the reference to the "freaky King" make this an easy call.
• Worst Hyped Ad: Diet Pepsi. The song sucks, and somebody obviously decided that having celebrities was more important than having a clever, well-written script.
• Best Beer Ad: "The magic refrigerator is back!" I think I lived next to those guys in college.
• Best Use of 80s Music: Lost. "Might as well face it…"
• Dumbest Sequel: Go-Daddy. I guess they were trying to make fun of something, but I couldn't figure out what that was.
• Most Gratuitous Use of Special Effects: Fusion. Come on, folks, it's a razor, it's only a razor.
• Most Gratuitous Use of Testosterone: Full Throttle. Real men drink coffee, by the way.
• Best Use of NFL Players: "I'm Going to Disney World." Well-made, and surprisingly well-acted.

Obligatory Super Bowl Prediction

On the one hand, I really don't care. On the other hand, I tend to root for the underdog, so I should go with Seattle. On the third hand, the underdog going into the playoffs was Pittsburgh, so I should side with the Steelers. On the fourth hand, Mary lived for a while in Seattle, so Seahawks it is. On the fifth hand, Seattle beat the Panthers, so how can I root for the team that deprived mine of a trip to Detroit? On the sixth hand, if my guys aren't going to win it all, then I want the team that beat them to take the Lombardi.

So: Seattle 27, Pittsburgh 24. And now, it's time to park my butt in front of the tube and watch the fun.

Update: 21-10 Pittsburgh, but come on — the refs really screwed Seattle in this game. However, the chili was good, the queso was gooey, and the chocolate chip cookies were delicious, so I'm not complaining too much.

Cash Land

Via the fine folks at my old stomping ground, Kicking Ass, comes this hilarious picture which succinctly illustrates the raison d'être of today's GOP. And it's even funnier when you find out which Republican bag man announced the kickoff of his re-election campaign next to this sign.

Bad Book Reviews are Good

I admit it — I like reading really scathing reviews. The kind of reviews that make you wince in embarrassment for the skewered writer, but also make you wish you could deploy such devastating rhetoric in real time against your own opponents, ideological or aesthetic. Reading these kinds of reviews is like being a witness to a horrible yet sublime accident, but one where no one is hurt except emotionally. It's schadenfreude at its best (and worst).

This past week has been a particularly good one in this respect, since I've come across two book reviews that had me wincing all the way through. First was this review of Bernard-Henri Lévy's American Vertigo: Traveling America in the Footsteps of Tocqueville by Garrison Keillor. Here's a choice bit:

And what's with the flurries of rhetorical questions? Is this how the French talk or is it something they save for books about America? "What is a Republican? What distinguishes a Republican in the America of today from a Democrat?" Lévy writes, like a student padding out a term paper. "What does this experience tell us?" he writes about the Mall of America. "What do we learn about American civilization from this mausoleum of merchandise, this funeral accumulation of false goods and nondesires in this end-of-the-world setting? What is the effect on the Americans of today of this confined space, this aquarium, where only a semblance of life seems to subsist?" And what is one to make of the series of questions — 20 in a row — about Hillary Clinton, in which Lévy implies she is seeking the White House to erase the shame of the Lewinsky affair? Was Lévy aware of the game 20 Questions, commonly played on long car trips in America? Are we to read this passage as a metaphor of American restlessness? Does he understand how irritating this is? Does he? Do you? May I stop now?

And then there is this choice piece of righteous indignation: Alan Wolfe's review of Rodney Stark's The Victory of Reason: How Christianity Led to Freedom, Capitalism, and Western Success. Here's my favorite part:

Jesus, Stark goes on, is responsible for more than liberating us from scrolls; to him goes the credit for all of Western civilization. If he had remained a Jew, we would live in a despotic world bereft of science and reason. Lots of women would die giving birth, and a significant percentage of children would not live past age five. Firmly ensconced in the dark ages, our societies would be horrendous places to inhabit, lacking "universities, banks, factories, eyeglasses, chimneys, and pianos."

Thought experiments have their place, but Stark's, it must immediately be said, is vile: even the most notorious anti-Semites give Jews credit for the banks.

I doubt I will read either book, but I wouldn't be surprised if I were to someday read these reviews again. Hurts so good!