Irrational Requests as Ethical Dilemma

Is it ethical to use fertility treatment when the mother already has six children?

How in the world does a woman with six children get a fertility doctor to help her have more _ eight more?

An ethical debate erupted Friday after it was learned that the Southern California woman who gave birth to octuplets this week had six children already.

Large multiple births “are presented on TV shows as a `Brady Bunch’ moment. They’re not,” fumed Arthur Caplan, bioethics chairman at the University of Pennsylvania. He noted the serious and sometimes lethal complications and crushing medical costs that often come with high-multiple births.

So I don’t use this solely to leapfrog to my concern, I’ll say no, it’s not ethical, although I won’t go so far as to say it should be prohibited. But if the facts are as they’re being speculated in the media, the doctor who administered these fertility treatments acted unethically.

Okay, so to jump to my question. We’re talking about whether this is ethical, but not enough people would realize the ethical dilemma this presents for the law. This woman can legally alter the genitals of six of her newborns, for whatever reason or no reason, while her other two newborns are legally protected from unnecessary genital surgery. The general consensus in the American medical and legal community is that this is ethical. No one should be surprised that a ridiculous case of fertility treatment for a woman with six kids can occur.

Only We the People go to jail for unpaid taxes.

I wrote about Tom Daschle not paying his taxes on Twitter this morning, but it warrants another mention, this time with a comment from David Boaz at Cato @ Liberty:

I sympathize with anybody trying to hold down his tax bill. Government is too big and too expensive, few of us feel we get our money’s worth from our taxes, and we all have better uses for our money than bridges to nowhere and free condoms. But honestly, shouldn’t people who want to increase taxes on the rest of us — like Daschle, Geithner, Eleanor Holmes Norton, Chairman Charles Rangel, Al Franken, Governor David Paterson’s top aide, Democratic National Convention staffers, Al Sharpton, and so on — pay their own taxes? [Links omitted for aesthetics]

Higher taxes are always about forcing the other guy to pay for what you think everyone should have. When it’s not about power, it’s about requiring people to care about the “right” outcomes.

But, never forget that it’s always about power.

Let me root, root, root for the home team, If they don’t win it’s a … Congressional takeover?

You knew that TARP would lead to public shaming and Congressional indifference to contracts, right?

U.S. Reps. Dennis Kucinich and Ted Poe are urging the Obama administration to demand that Citigroup drop its $400 million, 20-year naming rights deal for Citi Field, the New York Mets’ new stadium scheduled to open in April, because of $45 billion the bank received in government aid.

“At Citigroup, 50,000 people will lose their jobs. Yet in the boardroom of Citigroup, spending $400 million to put a name on stadium seems like a good idea,” said Kucinich, an Ohio Democrat.

Citigroup and the New York Mets signed a contract. Now, because it’s not a populist expenditure, it’s invalid and Congress thinks it can tell the two parties that the contract is worthless. Surely demonstrating that contracts can’t be relied upon will strengthen the long-term economy.

However, notice how Rep. Kucinich refers to Citigroup spending $400 million. That is spread across 20 years. Are Reps. Kucinich and Poe suggesting that the economy will be bad for the next 20 years? Are they suggesting that the banks will be under Congressional control for the next 20 years? I know the answer to the latter, but I want to know if they’re invoking the politicians favorite power grab, the permanent crisis. That’s the safe assumption.

I also wonder if Reps. Kucinich and Poe have evidence to support their implicit assumption that naming rights do not work as a marketing tool. Being seen on television at least 81 times per year, as well as every sports highlight show after those 81 home games, are valued at less than $20 million per year? Based on what evidence?

Politicians pledge to distort the economy.

Economically, we’re screwed because President Obama is offering mortgage help. That’s bad, but the Republican response shows that not even the opposition gets it. (I know, surprise.):

Republicans, who opposed the president’s stimulus package of over $800 billion largely because of its spending priorities, suggested mortgage help as well, proposing government-backed 4 percent fixed-rate mortgages for “any credit-worthy borrower,” Senate Republican Leader Mitch McConnell said.

“The availability of these low-interest loans would increase demand for houses significantly and low-interest mortgages would boost household income,” McConnell said in a separate radio address.

Unless people believe the near-future economy will be better, they’re not going to invest in housing, especially since a decent short-term memory will suggest that housing involves risk. But more importantly, isn’t artificially lowering the cost of an activity unwise?

The key is artificial. Sen. McConnell is offering no explanation for how he arrived at 4%, and I doubt he’s enough of an expert to determine that 4% is appropriate for “any (i.e. every) credit-worthy borrower”.

I don’t grasp how a low-interest mortgage increases household income, either. Does he mean disposable income? If so, does he mean only people with a high(er) interest rate mortgage already? For those who will enter the home buying market, will their mortgage be higher than their rent, even at 4%? This would decrease household disposable income. How will that help the economy?

Every time a politician interferes, that politician forgets that there are people who suffer from the decisions. Groups, as they exist for political posturing, are meaningless.

AIDS relief does not redefine moral behavior.

Although I largely ignore Michael Gerson’s columns because I know it’s going to be feel-good, big government social conservatism, I will defend him on one point from his column today defending ousted PEPFAR coordinator Dr. Mark Dybul and condemning the method of his ouster. Primarily, Gerson states:

A few radical “reproductive rights” groups — the fringe of a fringe — accused Dybul of advocating “abstinence only” programs in AIDS prevention. It was always a lie. Dybul consistently supported comprehensive prevention efforts that include abstinence, faithfulness and condom use — the approach that African governments themselves developed. …

I conducted a quick search to find proof on what I know about PEPFAR and found this quote from the New York Times, from December 14, 2006:

[Dr. Dybul] also warned that it was only one new weapon in the fight, adding, ”Prevention efforts must reinforce the A.B.C. approach — abstain, be faithful, and correct and consistent use of condoms.”

So Gerson’s point that Dr Dybul is being unfairly attacked on these grounds is accurate.

However, the “it” Dr. Dybul refers derives from the previous paragraph in the New York Times story, an angle I knew I’d find in my research.

Dr. Mark Dybul, executive director of President Bush’s $15 billion Emergency Plan for AIDS Relief, said in a statement that his agency ”will support implementation of safe medical male circumcision for H.I.V./AIDS prevention” if world health agencies recommend it.

From PEPFAR’s male circumcision brief, updated January 2009, here is a sample of PEPFAR’s work:

In Zambia, PEPFAR continues to support a broad approach to prevention which includes male circumcision. Safe and effective medical male circumcision services are now provided at various sites to reduce new HIV infections and other sexually transmitted diseases. Working with the Ministry of Health, male circumcision is offered at the University Teaching Hospital in Lusaka and the General Hospital in Livingstone, as well as through satellite facilities. PEPFAR is also supporting training, public health evaluation on neonatal circumcision, and the development of comprehensive prevention messages to accompany medical male circumcision services. [emphasis added]

This is an action overseen by an individual Gerson describes as “a great humanitarian physician — a man of faith and conscience”. I have no reason to question the second claim, but one and three are demonstrably false.

I do not expect anything better from the Obama administration’s eventual pick to replace Dr. Dybul. Always remember that when public health officials talk about voluntary, adult male circumcision, they never mean voluntary, adult. Never.

Capitalism versus Corporatism, or “People Don’t Invalidate Systems”

By now everyone is aware of the recent salmonella outbreak tied to peanut butter. The origin of the contaminated peanut butter is now known, and it allegedly includes some sketchy corporate behavior, as outlined in the first, non-snark-filled half of this FARK headline:

Contaminated peanut butter factory found salmonella 12 times in two years of internal tests… and still kept shipping. But don’t worry, industry will police itself

The second half takes an ideological swipe without bothering with logic used by advocates of free markets. The comments at FARK swing to both sides of the pendulum, as one expects in a fight on the Internets. But the volley conveys a critical flaw in how those who desire strong regulation (often to the point of central planning) and a marketing failure among free market advocates. The basic, paraphrased gist of the debate:

  1. FDA?
  2. People died! “Free markets” mean killing is okay!
  3. “Free market” means the company – Peanut Corporation of America – will go bankrupt.
  4. No.
  5. Yes.
  6. No!
  7. Yes!
  8. NO!
  9. YES!

Multiple arguments are in play here. The idea that free market advocates support negligent or intentional behavior that harms is uninformed silliness. The free market is about consequences. Build a good product that meets a need and customers will buy. Build a bad product that fails to meet a need or that harms and customers will refuse to buy. The idea is that incentives matter.

The ideological “free markets kill” approach ignores the spectrum of incentives, either out of disinterest or dishonesty. Selling a product that kills (in a non-predictable manner) has consequences1. This scandal will most likely bankrupt the Peanut Corporation of America through lost business and civil lawsuits, as it probably should. Executives will most likely face criminal prosecution. I can’t think of a single free market advocate who would argue that such an outcome would be unjust, if the facts are as they seem.

The essential fact is that a belief in free markets and capitalism is not a belief in corporatism. Free market advocates argue against government interference because government unfairly picks winners and losers. Regulations are often bad because they skew incentives. Want to bet Peanut Corporation of America will claim as a defense that the FDA, via authority it delegated to the Georgia Department of Agriculture, reviewed its plants and found no violations sufficient to deem this anything other than an unfortunate accident? Here, regulation builds a defense that “the government said it’s okay”. The facts appear unlikely to support that, but the excuse is viable in many cases (i.e. pharmaceutical regulation).

But subsidies skew incentives, as well. Look at ethanol subsidies and the subsequent, predictable increase in the price of corn. Subsidize behavior and you get more of it.

In the current salmonella outbreak, the FDA is incapable of policing every product produced in every factory. I do not seek to minimize any deaths, but how many deadly outbreaks2 actually occur? The costs of full regulation3, both in taxes and higher food prices, would overwhelm any marginal increase in safety. Some problems will slip through the regulatory framework. The question is ultimately why they happen, to which I think the reasonable answer is a basic justification for crime: Those involved thought they could get away with it.

This belief, a willingness to gamble that horrible outcomes will not result, is not surprising, but it arises from human psychology, not free market ideas. Again, no free market advocate is going to dismiss these deaths. There should be consequences. However, while further regulation probably could have prevented these deaths, the idea that more regulation will avoid such outcomes completely rests upon the mistaken assumption that we’ll always have the right regulations and the right regulators to implement them. We never will because humans are fallible in how we write laws, choose regulators, and enforce code.

Free market advocacy is about freeing individuals to pursue businesses and products they value, whether as seller or buyer. That also means freeing individuals from the influence of government picking A over B as the winner through regulation for reasons other than merit, as politicians and bureaucrats always will. Liberty is about freedom from harm, not freedom to harm. You don’t have to buy my product, and you’ll have recourse against me that I do not desire should I harm you. It takes a cynical outlook on individuals and liberty to miss that, I fear, but free market advocates also need to do a better job of pointing out the difference in capitalism and corporatism. We favor the former exclusively.

Update (2/13/09): Peanut Corporation of America to Liquidate.

1 Selling cigarettes may have fit this mold years ago. Today, cigarettes fail this test since we know the harms. Selling cigarettes is not the free market killing consumers.

2 Obligatory vegan statement: The majority of food-borne illness outbreaks result directly from meat, dairy, and egg production.

3 From the Washington Post article:

But Jean Halloran, director of food safety for Consumers Union, said if the government was adequately protecting the food supply, the outbreak could have been minimized or even prevented, and lives could have been saved. Major reforms in inspections and regulations are past due, she said.

“The average plant is inspected once every 10 years,” Halloran said. “This one was getting inspected a couple of times a year by Georgia, but neither they nor the FDA were taking enough enforcement action.”

Halloran’s statement exists in a vacuum of preferred outcomes, with no consideration for real costs. More Consumers Union nonsense here.

Fifty x Incompetence = Competence

It’s time to pick up the national switch to digital television once again since Congress is determined to somehow fix the problem by expanding the flaws of the transition plan.

Key senators have reached a compromise on a bill that would delay the nation’s switch to all-digital television from next month until June 12. A vote on the legislation is expected early next week.

Sen. John D. Rockefeller (D-W.Va.), chairman of the Commerce Committee, has been working with ranking member Sen. Kay Bailey Hutchison (R-Tex.), to draft legislation that also would give consumers more access to coupons for the converter boxes needed to continue receiving broadcasts.

Congress set the deadline years ago, yet that wasn’t enough. Four more months will fix it, even though a trip into any electronics store will reveal more than enough converters. Obviously that isn’t the problem. The supply is there. But the price isn’t right, hence more “free” coupons. Why should anyone doubt this will be solved by June 12th?

That’s not my point, though. This is:

“The shameful truth is that we are not poised to do this transition right,” Rockefeller said in a statement. “We are only weeks away from doing it dreadfully wrong — and leaving consumers with the consequences.”

The “shameful truth” is that Congress can’t manage a transition to digital television that will cost the government (i.e. us) less than $2 billion. The outcome will be “dreadfully wrong”. This is standard operating procedure. But don’t anyone worry about the ongoing bailouts of banks and consumers. There will be no shameful truth in how Congress spends $1 trillion. Borrowing always solves a spending problem. Consumers will get only benefits there, we’re told.

It takes an active commitment to ignorance to trust Congress and the President. I can think of no other explanation.

I’ll punish you tomorrow so that you look back and think today is a success.

Princeton economics professor Alan Krueger offers a national sales tax as a path to prosperity. The key bit:

Here is a suggestion to address both the short-run and long-run problems. I pose it only as a suggestion for serious discussion; I’m not sure it is the best way to go. But here goes: Why not pass a 5 percent consumption tax to take effect two years from now? There are many different ways to implement a consumption tax, but for simplicity think about a national sales tax.

So he prefaced it by saying it’s only a suggestion. It’s a path to prosperity that should be so obviously doomed to failure that an economics professor would trash it before submitting it to an editor, but still, the caveat is there. He continues:

In the short run, the anticipation of a consumption tax would encourage households to spend money now, rather than after the tax is in place. Along with the rest of the economic recovery package, this would help jump-start spending in the economy and thereby increase production and employment.

Just like the federal government, consumers can create prosperity by spending more. Somehow, defined as shifting spending from a post-tax world two years from now presumably to today’s pre-tax world. This is an interesting theory, but let me ask a question: If you know a 5% tax looms two years from now and you have a significant purchase planned more than two years from now, is that going to shift your spending to today? Or will it shift your spending to 1 year, 364 days from today? The two year window is pointless to get the economy rolling today, if we’re working under the silly notion that a tax increase will grow the economy.

Also, if you shift that spending from some date more than 2 years in the future to 1 year, 364 days in the future, have you increased (i.e. “jump-started”) consumer spending, or have you shifted the same spending around in time? Will this shifting in time increase production temporarily or permanently?

Notice, too, that the entire argument is built around the false assumptions that we need not question government spending and that tax increases have no negative effect on an economy.

Via Kip

Journalism is hard.

The CDC conducted a study and found that 0.5% of U.S. kids are vegetarian. The article continues for an eternity while trying to build on that topic. The first half accomplishes it presentation of introductory information. Vegetarians don’t eat meat, although some self-described vegetarians eat fish and poultry. It’s the usual stuff. Then, this:

Eating vegetarian can be very healthy — nutritionists often push kids to eat more fruits and vegetables, of course. For growing children, however, it’s important to get sufficient amounts of protein, vitamins B12 and D, iron, calcium and other important nutrients that most people get from meat, eggs and dairy.

You think that’s going to be a way to introduce vegan nutrition with facts. Beans and nuts contain protein. Many vegan foods, such as soymilk, are fortified with B12. Broccoli contains calcium. Those are all factual statements that support vegan nutrition.

Instead, the AP writer follows with this:

Also, vegetarian diets are not necessarily slimming. Some vegetarian kids cut out meat but fill up on doughnuts, french fries, soda or potato chips, experts said.

It’s a good thing omnivore kids don’t fill up on doughnuts, french fries, soda or potato chips. That alternative universe might require the writer to research alternate, plant-based sources for protein, vitamins B12 and D, iron, calcium and other important nutrients that people can get from healthy food that 99.5% of kids eat. You know, foods like bologna, fried eggs, and ice cream. That’s where protein, vitamins B12 and D, iron, calcium and other important nutrients come from, right? As long as they’re eating meat, eggs and dairy, they’re healthy?

Nonsense of the Day

Roger Ebert’s best films of 2008 review includes this about Che, the soon-to-be-released biopic of Che Guevara:

The epic journey of a 20th century icon, the Argentinian physician who became a comrade of Fidel Castro in the Cuban Revolu- tion and then moved to South America to support revolution there. Benicio del Toro is persuasive as the fiercely ethical firebrand, in a film that includes unusual and unfamiliar chapters in Che’s life. Steven Soderbergh’s film is 257 minutes long, but far from boring.

This generated the same reaction I had this morning when Howard Stern described Guevara as a freedom fighter when he introduced guest Benicio del Toro, who plays Guevara in Che. Ending dissent with murder is fiercely ethical? Agitating for dictatorship – with Che in charge, of course – is fighting for freedom?

I will never understand the bizarre fascination with Guevara as a hero.