Everyone thinks America Alone is about Islam and demography, but in fact it has a whole section in it on cheese, called “The Pasteurization is Prologue”. Page 181:
I’ve never subscribed to that whole “cheese-eating surrender-monkey” sneer promoted by my National Review colleague Jonah Goldberg. As a neocon warmonger, I yield to no one in my contempt for the French, but, that said, cheese-wise I feel they have the edge.
When I’m at the lunch counter in America and I order a cheeseburger and the waitress says, “American, Swiss or Cheddar?” I can’t tell the difference. They all taste of nothing. The only difference is that the slice of alleged Swiss is full of holes, so you’re getting less nothing for your buck. Then again, the holes also taste of nothing, and they’re less fattening. But, either way, cheese is not the battleground on which to demonstrate the superiority of the American way.
Most of the American cheeses bearing European names are bland rubbery eunuch versions of the real thing. I wouldn’t mind if this were merely the market at work, but it’s not. It’s the result of Big Government, of the Brieatollahs at the United States Department of Agriculture:
In America, unpasteurized un-aged raw cheese that would be standard in any Continental fromagerie is banned. Americans, so zealous in defense of their liberties when it comes to guns, are happy to roll over for the nanny state when it comes to the cheese board… The French may be surrender monkeys on the battlefield, but they don’t throw their hands up and flee in terror just because the Brie’s a bit ripe. It’s the Americans who are the cheese-surrendering eating-monkeys — who insist, oh, no, the only way to deal with this sliver of Roquefort is to set up a rigorous ongoing Hans Blix-type inspections regime.
I’m not exaggerating about that. Nothing gets past their eyes, and everything gets pasteurized. That’s why American “cheesemakers” have to keep putting stuff into the “cheddar” — sun-dried tomatoes, red peppers, chocolate chips — to give it some taste, because the cheese itself has none. And, if you try to bring in anything that does taste of something, the US Government’s Brie Team Six seizes it:
The US fate of the bright-orange, mild-tasting French cheese has been in jeopardy for months and the Food and Drug Administration has blocked all further imports.
Why? Because US regulators determined the cantaloupe-like rind of the cheese was covered with too many cheese mites, even though the tiny bugs give mimolette its unique flavor.
No formal ban has been put in place, but 1.5 tonnes (3,300 pounds) of cheese were blocked from being imported, and nothing is going through US customs.
“No formal ban has been put in place” — because that would involve legislators passing laws in a legislature and whatnot. So they just banned it anyway.
Mark Steyn, “Live Brie or Die!” SteynOnline.com, 2014-03-13
March 16, 2014
QotD: American “cheese”
Alcoholics Anonymous and addiction
In Maclean’s, Kate Lunau talks to Dr. Lance Dodes about Alcoholics Anonymous:
Dr. Lance Dodes has spent more than 35 years treating people who are battling addiction, including alcoholism. In his new book (co-written with Zachary Dodes), The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, Dodes takes a hard look at Alcoholics Anonymous, a worldwide organization that describes itself as a “non-professional fellowship of alcoholics helping other alcoholics get and stay sober.” Today, there are more than 5,000 AA groups in Canada alone, which are free and open to anyone. Dodes, a retired assistant clinical professor of psychiatry at Harvard Medical School, argues that some groups — and many for-profit private rehab centres based on the 12-step model — are often ineffective, and can cause further damage to addicts.
Q: How did you come to work on addiction?
A: I first became involved with alcoholism and addiction in the ’70s, when the place I was working, which is now part of Massachusetts General Hospital in Boston, needed to develop an alcoholism treatment unit. I was director of psychiatry, so I said, “I’ll develop it.” Afterward, I became involved in various addiction treatment programs, including running the state’s largest compulsive-gambling program. Over the years, I became very familiar with AA. It became clear that, while AA works for some people, the statistics just didn’t back it up. The real problem is that [doctors] refer 100 per cent of their patients with alcoholism to AA, and that’s the wrong thing to do 90 per cent of the time.
Q: AA has more than two million members around the world. You say its success rate is between five and 10 per cent. How, then, do you account for its enduring popularity?
A: AA is a proselytizing organization. The 12th step is to go out and spread the word, and they do. Because there are so many people in prominent positions who are members of AA, it gets tremendously good press. If AA were simply harmless, then I would agree that a seven per cent success rate is better than zero. But that’s not the case. It can be very destructive. According to AA, AA never fails — you fail. AA says that if you’re not doing well in the program, then it’s you. So you should go back and do the same thing you did before: Do more of the 12 steps, and go to more meetings.
March 3, 2014
What doesn’t kill you makes you stronger – bacon and booze
At The Register, Lester Haines fights the killjoys in public health journalism to bring forth the revolutionary booze-and-bacon diet:
“Bacon is particularly problematic,” doomwatched the Daily Mail, a noted proponent of the “if it’s tasty it’ll kill you” school of scientific killjoyery.
It gets worse. Scientists have indicated that bacon also reduces fertility, while a daily consumption of of more than 20g of processed meat in general — “equivalent to one meagre rasher of bacon” — is a surefire shortcut to the hereafter.
Or so they’d have you believe. Among the amazing powers of bacon is its ability to cure hangovers. The negative effects of excessive alcohol consumption are well known — impotence, cirrhosis of the liver, maudlin pub musings, alcopop-fuelled teen pregnancies, the Saturday-night reduction of British city centres to vomit-spattered warzones, and so forth — but booze too has extraordinary properties.
In fact, it benefits cardiovascular health, fights asthma, provides immunity to Mike Tyson and, critically, wards off dementia and makes you clever.
So, here’s the thing: if bacon can be used to combat the negatives effects of alcohol, while alcohol can prevent you from losing your marbles as a result using bacon to counter the downside of alcohol (something we have dubbed the “Baco-Booze Harmonious Feedback Loop”), then you are in a position to exploit the increased intelligence alcohol confers.
March 2, 2014
QotD: The voices are coming from inside your head
The thesis of the article was simple: though the content of schizophrenic delusions changes wildly in different cultural contexts, there’s an underlying motivation for them that never varies and produces a fundamental sameness.
The simple, constant thing is that delusional schizophrenics lose the capability to identify all the thoughts in their head as belonging to themselves. In an effort to make sense of their experience, they invent elaborate theories which attribute their disconnected thoughts to external agencies. Gods, demons, orbital mind-control lasers — the content of such delusions varies wildly, but the function is always the same — to restore a sense of causal order to the schizophrenic’s universe, to impose a narrative on the eruptions that he or she can no longer recognize as “self”.
It’s a startling shift in perspective to realize that the construction of schizophrenic delusions arises from the same drive that yields scientific theory-building. Both are Heideggerian rearrangements of the cognitive toolkit, strategies driven by the necessity of coping with the experienced world. The schizophrenic’s tragedy is that the most important fact about his or her experiential world (how much of it is self looking at self) is inaccessible.
Eric S. Raymond, “Sometimes I hear voices”, Armed and Dangerous, 2013-10-06
February 20, 2014
Anti-tobacco campaigners – “a great bunch of puritanical Cnuts”
In sp!ked, Rob Lyons looks at the way e-cigarettes are being marketed in the UK and how it’s driving anti-tobacco campaigners absolutely insane:
For the tobacco-control lobby, an advert like Dorff’s is an absolute nightmare. It makes no health claims. It is clearly targeted at adults. It plays to the fact that even smokers dislike aspects of old-fashioned cigarettes, and are happy to compromise in order to get most of the pleasure of smoking without the hassle or the irritation to others. And then – God forbid – it even plays to the annoyance of smokers at the health fanatics. The last thing smoke dodgers want is for anyone to be able to take their freedom back. Even the existence of the sanitised offer from Vype’s say-nothing advert is anathema.
This was made abundantly clear in a report published by Cancer Research UK last year, The marketing of electronic cigarettes in the UK [PDF]. The authors are forced to admit that e-cigs ‘are accepted as being much safer than their conventional equivalents, so if smokers can be encouraged to switch there is the potential for significant public health gain’.
However, this message is quickly lost in a cloud of public-health cant. The threats, say the authors, include concerns that ‘hard-won tobacco-control policies (smokefree public places, the ad ban, age restricted sales, tobacco industry denormalisation, POS [point-of-sale] restrictions) are being undermined’ and that ‘there is evidence that young people, who have always been the key to the long-term viability of the tobacco industry, may be being pulled into the market’. The danger, say the authors, is that tobacco companies don’t want you to give up your addiction, just switch to a different delivery system. The problem with this argument is that the new delivery system is much, much safer. Why shouldn’t corporations try to sell us safe products?
[…]
In reality, what the anti-tobacco lobbyists (and their fans in Westminster and Whitehall) are really afraid of is the loss of their power and influence over our lives. They fear they will be helpless against the tide of e-cigs, like a great bunch of puritanical Cnuts. (Note to sub-editor: that’s definitely ‘Cnuts’, as in the Danish king who famously – probably apocryphally – tried to turn back the sea. Honest.)
E-cigs are a safe, practical alternative to smoking. For all the huffing and putting-a-stop-to-puffing, tobacco control has been an illiberal failure. E-cigs are encouraging smokers to switch, cut down or stop altogether far more successfully than all the bans, taxes, restrictions and useless nicotine-replacement therapies that have gone before. ‘Vaping’ is an unexpected but nonetheless happy success story.
February 7, 2014
QotD: Writer’s block
The formula of the argument is simple and familiar: to dispose of a problem all that is necessary is to deny that it exists. But there are plenty of men, I believe, who find themselves unable to resolve the difficulty in any such cavalier manner men whose chief burden and distinction, in fact, is that they do not employ formulae in their thinking, but are thrown constantly upon industry, ingenuity and the favor of God. Among such men there remains a good deal more belief in what is vaguely called inspiration. They know by hard experience that there are days when their ideas flow freely and clearly, and days when they are dammed up damnably. Say a man of that sort has a good day. For some reason quite incomprehensible to him all his mental processes take on an amazing ease and slickness. Almost without conscious effort he solves technical problems that have badgered him for weeks. He is full of novel expedients, extraordinary efficiencies, strange cunnings. He has a feeling that he has suddenly and unaccountably broken through a wall, dispersed a fog, got himself out of the dark. So he does a double or triple stint of the best work that he is capable of maybe of far better work than he has ever been capable of before and goes to bed impatient for the morrow. And on the morrow he discovers to his consternation that he has become almost idiotic, and quite incapable of any work at all.
I challenge any man who trades in ideas to deny that he has this experience. The truth is that he has it constantly. It overtakes poets and contrapuntists, critics and dramatists, philosophers and journalists; it may even be shared, so far as I know, by advertisement writers, chautauqua orators and the rev. clergy. The characters that all anatomists of melancholy mark in it are the irregular ebb and flow of the tides, and the impossibility of getting them under any sort of rational control. The brain, as it were, stands to one side and watches itself pitching and tossing, full of agony but essentially helpless. Here the man of creative imagination pays a ghastly price for all his superiorities and immunities; nature takes revenge upon him for dreaming of improvements in the scheme of things. Sitting there in his lonely room, gnawing the handle of his pen, racked by his infernal quest, horribly bedevilled by incessant flashes of itching, toothache, eye-strain and evil conscience thus tortured, he makes atonement for his crime of being intelligent. The normal man, the healthy and honest man, the good citizen and householder this man, I daresay, knows nothing of all that travail. It is reserved especially for artists and metaphysicians. It is the particular penalty of those who pursue strange butterflies into dark forests, and go fishing in enchanted and forbidden streams.
H.L. Mencken, “The Divine Afflatus”, Prejudices, Second Series, 1920
February 6, 2014
E-cigarettes – growth industry or doomed by regulatory overstretch
Megan McArdle discusses the past, present, and potential future for the e-cigarette industry:
In its simplest form, an e-cigarette is a cartridge filled with a nicotine solution and a battery powering a coil that heats the solution into vapor, which one sucks in and exhales like smoke. Typically, it looks like a regular cigarette, except the tip, embedded with an LED, often glows blue instead of red. The active ingredient in e-cigarettes is the same nicotine found in cigarettes and nicotine patches.
The effects of inhaling nicotine vapor are not totally understood, but there is no evidence to date that it causes cancer. Experts and logic seem to agree that it’s a lot better than setting chopped-up tobacco leaves on fire and inhaling the nicotine along with thousands of combustion byproducts, some of which are definitely carcinogenic. Because cancer is the main drawback of smoking for a lot of people, the delivery of nicotine without lighting a cigarette is very attractive. And because it produces a wispy vapor instead of acrid smoke, an e-cigarette lets you bring your smoking back indoors, where lighting up in an enclosed space is no longer socially, or legally, acceptable.
[…]
A primitive, battery-operated “smokeless non-tobacco cigarette” was patented as early as 1963 and described in Popular Mechanics in 1965. Thomas Schelling, a Nobel prize-winning economist who helped start the Institute for the Study of Smoking Behavior and Policy at Harvard University’s Kennedy School in the 1980s, recalls that people in the 1960s were talking about a charcoal-based vaporizer that would heat some sort of nicotine solution. While those early versions might have been safer than a regular cigarette, they were too expensive and cumbersome to become a substitute for a pack of Camels in a country where, as Schelling notes, “you’re never more than 5 or 10 minutes away from a smoke.”
In a way, electronic cigarettes were made possible by cell phones. The drive to make phones smaller and lengthen their battery life led to the development of batteries and equipment small enough to fit in a container the size and shape of a cigarette. There’s some dispute over who invented the modern e-cigarette, but the first commercially marketed device was created by a Chinese pharmacist, Hon Lik, and introduced to the Chinese market as a smoking cessation device in 2004.
In the same way that alcohol comes in various guises (many carefully crafted to appeal to beginners: sweet as soda pop, for example), e-cigarettes are available in many different flavours:
E-cigarette cartridges come in classic tobacco and menthol flavors — Verleur’s company even offers V2 Red, Sahara, and Congress, clearly aimed at loyal smokers of Marlboros, Camels, and Parliaments. But most companies also have less conventional flavors. Blu offers Peach Schnapps, Java Jolt, Vivid Vanilla, Cherry Crush, and Piña Colada, presumably for people who don’t just like a drink with a cigarette, but in one.
January 24, 2014
January 21, 2014
Euthanasia on TV and in real life
It’s been many years since I watched an episode of Coronation Street, so I was a bit surprised to find that the show’s writers are “political”, at least on some issues:
Many a soap-opera storyline has created a news story in itself. So it was in the case of Hayley Cropper, a character on a British soap, Coronation Street. News of what happens to Hayley, in an episode to be shown tonight, created a furore when the press release for the story went out last Tuesday. The dilemma for the writers was how to kill off a character who had been a mainstay of the programme since 1998, when she was introduced as the first transsexual character. The answer, provided by producer Stuart Blackburn, was to have the character dying of pancreatic cancer, but finishing herself off with a cocktail of drugs in an on-screen suicide.
Julie Hesmondhalgh, the actor who plays Hayley, called for a discussion on legalising assisted suicide. She was backed by Sara Wootton, chief executive of Dignity in Dying, who praised the show’s ‘sensible and sensitive handling of assisted dying’. Lord Falconer, whose Assisted Dying Bill will be introduced in the House of Lords in the coming months, penned an article in the Sun. The Sun’s editorial called for a change in the law and the newspaper published the results of a poll indicating that 69 per cent of Britons support the legalisation of assisted suicide for the terminally ill.
[…]
It is difficult not to suspect – despite the even-handedness of the treatment of the issue (the character’s on-screen husband, Roy Cropper, opposes Hayley’s decision) – that the programme is part of the well-funded campaign to legalise assisted suicide. Stuart Blackburn had previously explored the same issue while at a rival soap, Emmerdale. (He perhaps risks becoming the Jack Kevorkian of the soap world.) Hesmondhalgh was forthright about her support for a change in the law in several interviews, and many journalists seem poised to call again for the legalisation of assisted suicide.
But it is entirely appropriate that a fictional plotline is used to promote legalising assisted suicide. The reason that so many people wish to have the ‘right to die’ is based on the morbid imagination of the ‘worried well’, traded on so effectively by right-to-die campaigners. ‘What if it happened to YOU…?’ is the plotline of Dignity in Dying and other organisations that campaign for legalised assisted suicide.
There are arguments on both sides of this issue (personally, I’m in favour of making it legal), but there are concerns that less-than-scrupulous family members might attempt to “hurry” an elderly or infirm parent or relative to a decision that wouldn’t really be voluntary.
It’s also an issue that came up this weekend, as one of my online acquaintances (we’d never met in person, but we both belonged to a special interest mailing list and had had several email discussions) committed suicide with his wife last week. Maarten and Irma apparently faced an unpleasant future in their declining years and mutually decided that their time had come. While euthanasia is legal in the Netherlands, it does not seem that Maarten and Irma followed the letter of the law in their case:
Euthanasia in the Netherlands is regulated by the “Termination of Life on Request and Assisted Suicide (Review Procedures) Act” from 2002. It states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient’s request, the patient’s suffering (unbearable and hopeless), the information provided to the patient, the presence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians to report euthanasia to a review committee.
The family is, understandably, not providing a lot of detail but said that they were found in bed, hand in hand and “together, peaceful and loving” but did not specify how they had died.
Becoming dependent on whomever or whatever, or seeing your partner slowly fading away, are situations we do not ever want to contemplate, therefore we have, in good health, clear of mind, together 150 years old, in our own bed, hand in hand, ended our lives.
At risk of sounding trite, I’m saddened that they chose to do this, but I respect their right to make that decision. It cannot have been an easy one. Rest in peace.
January 8, 2014
David Harsanyi on Colorado’s recent marijuana legalization
On the one hand, he’s delighted that something he advocated for years finally came to pass. On the other, well, he’s still also in favour of adults being allowed to make decisions on what they put into their bodies (and owning the consequences of their actions), so perhaps we only need the one hand after all.
As a Denver Post columnist from 2004-2011, I spent a considerable amount of time writing pieces advocating for the legalization of pot. So I was happy when the state became one of the first to decriminalize small amounts of “recreational” marijuana. I believe the War on Drugs is a tragically misplaced use of resources; an immoral venture that produces far more suffering than it alleviates. And on a philosophical level, I believe that adults should be permitted to ingest whatever they desire — including, but not limited to, trans-fats, tobacco, cough syrup, colossal-sized sodas, and so on — as long as they live with the consequences.
You know, that old chestnut.
Unrealistic? Maybe. But less so than allowing myself to believe human behavior can/should be endlessly nudged, cajoled and coerced by politicians.
So, naturally, I was curious to see how marijuana sales in Colorado would shake out. According to the Denver Post, there are nearly 40 stores in Colorado licensed to sell “recreational” pot. Medical marijuana has been legal for more than a decade. (And, having spent time covering medical pot “caregivers” — or, rather, barely coherent stoners selling cannabis to other barely coherent stoners, a majority of whom suffer from ailments that an Excedrin could probably alleviate — it will be a relief to see that ruse come to end. I’m not saying marijuana doesn’t possess medicinal uses. I’m saying that most medicinal users are frauds.)
Not surprisingly, pot stores can’t keep up with demand for a hit of recreational tetrahydrocannabinol. Outside of Denver shops, people are waiting for up to five hours to buy some well-taxed and “regulated” cannabis. The pot tourists have also arrived. All this, the Denver Post estimates, will translate into $40 million of additional tax revenue in 2014 — the real reason legalization in Colorado became a reality.
January 4, 2014
By DSM-5 standards, most of us are suffering from personality disorders
From the last issue of the City Journal, Theodore Dalrymple‘s critique of the latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a rather wide-ranging diagnosis that applies to a huge number of people:
The overlap between straightforwardly pathological conditions (in Szasz’s sense) and those that result from social, psychological, or personal factors, or from bad moral choices, suggests that psychiatrists should show discretion in what they regard as genuine illness. The state of ignorance in which psychiatrists now practice, which will probably endure, ensures that they will often be wrong; but no one who has encountered, say, a manic in full flight is likely to doubt that he is in the presence of illness. But nor would it be easy, then, to see so-called factitious disorder, which consists of “falsification of physical or psychological signs and symptoms, or induction of injury or disease, associated with identified deception” in quite the same light: that is, to grant the same status to someone pretending to be ill as to someone genuinely ill.
Yet this is precisely what the DSM-5 does, establishing its authors’ lack of common sense, the quality that psychiatrists, perhaps more than any other kind of doctor, need. The manual’s lack of common sense would be amusing were it not destined to be taken with superstitious seriousness by psychiatrists around the world, as well as by insurers and lawyers.
The section of the volume devoted to personality disorders proves the point. Among the criteria for personality disorders in general are the following:
A: An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, in fields such as thought, emotion, interpersonal relations and impulse control . . .
B: The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
C: The enduring pattern leads to clinically significant distress or impairment in social, occupational or other important areas of functioning.
D: The pattern is stable and of long duration.
The DSM-5 then informs us that more than one in seven people have such a lifelong disorder — adding up to 45 million Americans and even more Europeans. These astonishing numbers give the authors not a moment’s pause (any more than does the fact that their own prevalence rates suggest that the average American suffers from more than two psychiatric disorders in any one year). Several undesirable characteristics must be present in an individual for a diagnosis of personality disorder to apply. Considering those characteristics, and that such a significant portion of the Western population supposedly exhibits many of them, either a mass outbreak of human nastiness and inability to deal with everyday life must have occurred, or the whole business of diagnosis must be dubious or even ridiculous.
Here is a random list of some of the characteristics that, in the DSM-5, make up personality disorders of various kinds:
Unjustified suspicions that others are harming, exploiting or deceiving.
Persistently grudge-bearing.
Detachment from social relations and limited expression of emotion.
Behavior or appearance that is odd, eccentric or peculiar.
Deceitfulness.
Persistent irresponsibility.
Indifference to risk to self or others.
Irritability and aggressiveness.
Lack of remorse.
Recurrent suicidal behavior, gestures or threats, or self-mutilation.
Inappropriately intense anger, frequent displays of temper.
Rapidly shifting and shallow expressions of emotion.
Use of physical appearance to draw attention to self.
Self-dramatization, theatricality.
Grandiosity.
Requirement for excessive admiration.
Sense of entitlement.
Interpersonal exploitativeness.
Lack of empathy.
Enviousness of others.
Arrogance and haughtiness.
Unwillingness to become involved with people.
Sense of social ineptitude and inferiority.
Avoidance of risk.
Difficulty in expressing disagreement with others because of fear of disapproval, i.e., pusillanimity.
Feeling of helplessness when alone.
Preoccupation with details, rules, lists, order, organization or schedules.
Excessive devotion to work.
Over-conscientiousness or scrupulousness.
Reluctance to delegate.
Rigidity and stubbornness.
The diagnoses for most of the disorders require at least four of the undesirable characteristics to be present, predominant, and persistent. One is reminded of the King of Brobdingnag’s view of Gulliver’s countrymen: “I cannot but conclude the bulk of your natives to be the most pernicious race of little odious vermin that nature ever suffered to crawl upon the surface of the earth.” Lest anyone object that “only” one in seven people suffers from personality disorders, and that therefore the King of Brobdingnag’s opinion of Western humanity — that it suffers from the “worst effects that avarice, faction, hypocrisy, perfidiousness, cruelty, rage, madness, hatred, envy, lust, malice, and ambition, could produce” — is not relevant, one must add that, for the DSM-5, people with personality disorders are merely the most extreme exemplars of their type. And if only the extremes have four or more undesirable and frequently horrible dominating characteristics, many individuals must have one, two, or even three such characteristics. If the DSM-5 reflects the American Psychiatric Association’s views, then that organization clearly views humanity with Swiftian distaste. Yet its distaste is not that of a disappointed lover (and certainly not expressed with Swift’s genius) but is motivated, one suspects, by the hope of an endless supply of patients. For those with psychiatric disorders need psychiatrists.
December 23, 2013
Psychiatry does not seek “to colonise everyday life – rather, everyday life now invites colonisation by psychiatry”
In Spiked, Sandy Starr reviews Gary Greenberg’s recently published The Book of Woe:
There is an inevitable contingency about diagnostic categories, particularly when it comes to psychiatry. Greenberg argues that for all the useful work that goes into constructing these categories, psychiatric diagnosis has a ‘self-validating nature…by which once you’ve created a diagnostic category, the fact that people fit into it becomes evidence that the disorder exists’. Greenberg reminds us that ‘while many diagnoses are made on clinical signs and symptoms rather than on lab tests or other external validators, only in psychiatry are all diagnoses made that way’.
It’s worth adding that this may be changing. As psychiatry seeks to predicate itself more and more upon genetics and neuroscience, there are expectations in some circles that biochemical diagnostic tests for psychiatric disorders will follow ineluctably. This prospect does not reassure me. Psychiatry is attempting the difficult feat of relocating its foundations without toppling its façade, and this involves elisions — several of which are discussed by Greenberg — that leave me feeling less persuaded of the profession’s credentials, not more.
[…]
That said, one can certainly appreciate the need for psychiatry to appear coherent and confident, given the far-reaching consequences of the DSM’s contents. Greenberg explains, for example, how the use of a single ‘and’ where an ‘or’ might have been used, in the definition of ‘paedophilia’ that made its way into the fourth edition, inadvertently made it far easier for US authorities to detain indefinitely (on psychiatric grounds) people who had been convicted of sexual offences against minors. In other words, a single use of the word ‘and’ in the DSM led to a complex domain of morality and law — the culpability (or otherwise) of people charged with sexual offences in various circumstances, and proportionate sentencing for their crimes — becoming subordinate to the considerations of psychiatry.
[…]
‘Once you start to think of your troubles as a disease, your idea of yourself, which is to say who you are, changes’, warns Greenberg. But while psychiatry gives a diagnostic imprimatur to our expectations of ourselves and of one another, psychiatry is not solely capable of bringing about a wholesale alteration of these expectations. To understand what else might account for a psychiatric turn in society, one needs to recognise that we live in a culture in which our adult capacities are constantly denigrated, in which victimhood has become one of the few widely recognised sources of authority, and in which we are constantly encouraged from all directions not only to put our problems on public display (rather than addressing them within the intimate confines of trusted friends, family or — in extremis — psychotherapists or even psychiatrists), but also to assume that our problems will most likely afflict us in perpetuity.
It’s not so much the case that psychiatry now seeks to colonise everyday life — rather, everyday life now invites colonisation by psychiatry. In circumstances such as these, even the most well-meaning and scrupulous psychiatrist might struggle to parse the suffering and idiosyncrasy they encounter, so as to partition it sensibly into the pathological and the normal. Greenberg’s barbs against psychiatry may be well deserved, and are certainly grounded in tantalising insider detail and no small amount of wit. But they represent an incomplete picture of the dynamics he sets out to get to grips with, which lie outside the institution of psychiatry as much as they lie within.
December 21, 2013
Overzealous regulators create nationwide Sriracha shortage
Baylen Linnekin on the latest attempt to be safer-than-safe in food regulation:
Last week California health regulators ordered the makers of Sriracha hot sauce to suspend operations for 30 days. The 30-day hold comes despite the fact the product has been on the market for more than three decades and that “no recall has been ordered and no pathogenic bacteria have been found[.]”
So what’s the issue?
The problem, reports the Pasadena Star News, is that Sriracha is a raw food.
“Because Sriracha is not cooked, only mashed and blended, Huy Fong needs to make sure its bottles won’t harbor dangerous bacteria,” writes the Star News.
Aren’t three decades of sales sufficient proof of that fact?
“The regulations outlining this process have been in existence for years,” writes California health department official Anita Gore, in a statement she sent to L.A. Weekly, “but the modified production requirements were established for the firm this year.”
In other words, the state changed the rules of the game.
I’m starting to think that Megan McArdle is a bit jaundiced about Obamacare
Otherwise, how can you account for running a column titled like this?
Obamacare Initiates Self-Destruction Sequence
On Wednesday, Politico’s Carrie Budoff Brown reported that the administration was saying fewer than 500,000 people had actually lost insurance due to Obamacare-induced cancellations. This struck me as a strange leak: Half a million is a lot less than many people (including me) have been estimating, but it is still not a small number, and the administration has tended to sit on negative information until the last possible moment.
Yesterday, we had a more official announcement from the administration: Anyone who has had their policies cancelled will be exempt from the individual mandate next year. The administration is also allowing those people to buy catastrophic plans, even if they’re over 30.
What to make of these two statements? On the one hand, the administration is trying to minimize the number of people who have been affected by cancellations, and on the other hand, it is unveiling a fix to the problem of cancellations. And these are not minor changes.
[…]
The White House is focused on winning the news cycle, day by day, not the kind of detached technocratic policymaking that they, and the law’s other supporters, hoped this law would embody. Does your fix create problems later, cause costs to spiral or people to drop out of the insurance market, or lead to political pressure to expand the fixes in ways that critically undermine the law? Well, that’s preferable to sudden death right now.
However incoherent these fixes may seem, they send two messages, loud and clear. The first is that although liberal pundits may think that the law is a done deal, impossible to repeal, the administration does not believe that. The willingness to take large risks with the program’s stability indicates that the administration thinks it has a huge amount to lose — that the White House is in a battle for the program’s very existence, not a few marginal House and Senate seats.
And the second is that enrollment probably isn’t what the administration was hoping. I don’t know that we’ll start Jan. 1 with fewer people insured than we had a year ago, but this certainly shouldn’t make us optimistic. It’s not like people who lost their insurance due to Obamacare, and now can’t afford to replace their policy, are going to be happy that they’re exempted from the mandate; they’re still going to be pretty mad. This is at best, damage control. Which suggests that the administration is expecting a fair amount of damage.
December 2, 2013
The FDA and 23andMe
Kyle Smith on the FDA’s sudden interest in shutting down private DNA testing company 23andMe:
… the FDA has the power to regulate medical devices, which is the pretext it is using to stop 23andMe. Ordering it to stop selling its personal genome service, the FDA declared that the tube “is a device within the meaning of section 201(h) of the FD&C Act, 21 U.S.C. 321(h), because it is intended for use in the diagnosis of disease or other conditions or in the cure, mitigation, treatment or prevention of disease, or is intended to affect the structure or function of the body.’
It would seem that 23andMe could simply put the words, “not intended for us in the diagnosis, cure, mitigation, treatment or prevention of disease” on its website and satisfy the FDA, but we all know that the motto of today’s federales is “We make it up as we go along.” The FDA seems determined to conduct a lengthy war with 23andMe.
[…]
Using the same reasoning, the FDA might as well shut down WebMd.com because people might type their symptoms into the site, and the response might affect whether or not they choose to go to a doctor. Any computer or iPhone thereby becomes a “medical device” that people can use for the “diagnosis, cure, mitigation, treatment or prevention of disease.”
Come to think of it, that thermometer you use to check your temperature is pretty dangerous too — it might give you either a false positive or a false negative — but why stop there? You exercise to mitigate or prevent disease, don’t you? Maybe the FDA should take your running shoes and your yoga pants away.
