Abortion Issue Major Deciding Factor for Catholic Voters

I realize that this is probably kind of like saying "water issue major deciding factor for fish voters," but:

Many "small-town Catholics" are opting to support McCain on the abortion issue alone. Or so they say. That can't be the whole picture:

One parishioner ruled out voting for Mr. Obama explicitly because he is black. “Are they going to make it the Black House?” Ray McCormick asked, to embarrassed hushing from a half dozen others gathered around the rectory kitchen. (Five of the six, all lifelong Democrats who supported Mrs. Clinton in the primary, said they now lean toward Mr. McCain.)

Man, you can still say things like that in public without being ostracized for being a terrible human being? We sure have made progress in America these past 50 years or so.

Many parishes distributed a voter guide, produced by an outside conservative Catholic group called Catholic Answers, which identified five “nonnegotiable” issues for faithful voters: abortion, embryonic stem-cell research, human cloning, euthanasia and same-sex marriage.

I think that's pretty stellar. It's totally acceptable to re-elect a member of a political party whose flawed policies have sent our economy down the tubes. We should definitely consider with seriousness a candidate whose health care plan is no health care plan at all. We should get behind a man who doesn't seem to realize that "clean coal" technology doesn't fix the fossil fuel reliance problem.

We should do all of these things because we care more about blastocysts than ambulatory human beings and the idea of gays having proper civil rights is just terrifying.

America the beautiful.

(H/t Mike the Mad Biologist).

Doing One's Duty

Most people have heard of the Hippocratic oath. Physicians traditionally took the oath upon graduation. Some parts of the oath are less applicable today; I think a lot of people would object to swearing in the name of a bunch of Greek gods. And while some doctors may not want to perform abortions, I think that it's unlikely that anyone is going to prescribe insertion of a silicone ring as a method of doing so. You get the idea.

But did you know that there's a pharmacist's oath? And a written code of ethics?

The oath is pretty brief. But that's good. It's concise. Here's what it comes down to: You, as a pharmacist, have obligated yourself to serve people. You're going to do this by knowing lots of stuff about drugs.

Likewise, the code of ethics is pretty to the point. You're going to serve patients, and you're going to do your best to be fair about it. You're going to respect and utilize the knowledge of other professionals. And you're going to respect your patients' autonomy.

So why do so many pharmacists think that it's somehow acceptable to refuse to dispense contraceptives?

Now, what I think this guy (Koelzer) is doing is stupid. But in one sense, he's doing this the right way. He's started his own pharmacy. He is not asking businesses that he does not own to make a special exception for his religious beliefs. If people want to patronize a pharmacy that refuses to stock contraceptives, it deserves to stay open as much as a pizza parlor that won't stock non-Kosher toppings. It would be an unfair imposition to tell Koelzer that he has to shut down his pharmacy, because he has the right to run whatever kind of business he wants. It would be wrong.

Koelzer might be a good business owner. But is Koelzer a good pharmacist?

I don't think so, because he's violating the pharmacist's code of ethics. He's violating his oath. He swore to make patient care his first priority--and he isn't. Guaranteeing women control over their own reproduction is patient care. It's not some kind of luxury. Koelzer might say that if women want to control their reproduction that they should refuse sex. But that's not respecting his patient's autonomy, either. His patients in search of contraceptives have clearly decided that they would like to have sex. A lot of people who use contraceptives are married, so this isn't just about sinful, blasphemous fornicators.

So if you want contraceptives, you won't go to his pharmacy. He owns his own business. It's his right not to offer them, and it's your right to shop somewhere else.

But he's still a bad pharmacist.

"Pray for McCain's Death"?

You know, when I started this blog I specifically told myself I didn't want to get into talking about politics except when necessary. I wanted to talk about pharmacotherapy and pharmacoeconomics and maybe the politics of medicine, but I really can't resist passing this along. Hat tip to Ed Brayton (and also compliments to PZ Myers, who also mentioned this story):

Palin is a Christian, so she ought to get elected president. Here's the "plan":

1. Vote Constitution Party. (I vote my conscience and cannot support McCain even with Palin.)

2. Hope and pray for McCain/Palin to win. (I am an idealist, but also a realist!)

3. Pray for John McCain's salvation and pray specific imprecatory prayers if he fails to pro-actively defend the sanctity of human life. (Google The Forerunner's articles on Impecatory Prayer if you don't understand this.)

You can't make this stuff up, folks. Some people are totally batshit crazy. Even if you believe in the existence of a god or gods, explain to me how it's even remotely moral to pray for someone's death so that you can get the president you want? Aren't these the same people who are always saying that the ends don't justify the means (which is why abortion is terrible, even if it's to save a woman's life)?

I just don't get it.

FYI, for anyone who's going to come along and say, "no one is praying for McCain's death!" I did as the writer suggests and looked up "impecatory prayer," which is actually spelled "imprecatory prayer," but you will get a billion google results for the former because everyone is reposting this story.

Anyway, imprecatory prayer is when you pray for God to help you hurt somebody else or defeat some enemy (because supposedly you are praying for a "righteous" reason, otherwise God won't help you and you're a dirty, dirty sinner. What is "righteous" is presumably up to the individual to decide by reedin' his Biiiiible).

Repetition =/= Truth

Apparently Tim Pawlenty, governor of Minnesota, was recently questioned about his position on teaching creationism/intelligent design--mostly because it's something that's come up with VP Sarah Palin, who favors "teaching the controversy."

GOV. PAWLENTY: I saw her comments on it yesterday, and I thought they were appropriate, which is, you know, let's -- if there are competing theories, and they are credible, her view of it was, according to the comments in the newspaper, allow them all to be presented or allow them both to be presented so students could be exposed to both or more and have a chance to be exposed to the various theories and make up their own minds.

Emphasis mine.

That's it. Full-stop. If they are credible. They aren't.

Evolution is a scientific theory. So is natural selection. They are supported by data, research, and observation. They don't just explain something, they invite further questions. How do things evolve? What pressures favor which adaptations? What conditions affect the visible "rate" of evolution? Thousands of issues are being explored by biologists using what we know about evolution as a starting point because it's been thoroughly demonstrated that it happens.

Creationism doesn't invite any serious questions that can actually be answered ("so, who is this designer, anyway?"). It doesn't present any hypothesis other than "stuff was designed," and that hypothesis isn't scientifically valid because it isn't testable. It is not a competing theory because it is not science.

It's disgusting that people are offended that their children are learning science in science classes because science apparently offends their theological sensibilities. And the politicians that are using this talking point--"it's a local issue"--are doing the smart thing, politically, and dodging the issue altogether. They're not saying they don't have an opinion. They're saying that they won't voice their opinion because they're afraid of alienating some portion of their constituency. No political candidate who wants to keep his career is going to stand up in front of America's 75% Christian population and tell them that their faith and beliefs are irrelevant when it comes to determining what is and isn't verifiably true.

Even if local school boards don't want their kids exposed to scary ideas like evolution, it's a waste of taxpayer dollars to teach them bullshit instead just so that they can be sheltered from theologically unpalatable truths.

A Remarkable Lack of Self-awareness

A tragic story released today by the Chicago Tribune really makes you wonder about people's abilities to critically examine their own point of view--even when lives are on the line.

Police are investigating an 11-year-old girl's death from an undiagnosed, treatable form of diabetes after her parents chose to pray for her rather than take her to a doctor...

...the girl's mother, Leilani Neumann, said that she and her family believe in the Bible and that healing comes from God, but that they do not belong to an organized religion or faith, are not fanatics and have nothing against doctors. [emphasis mine]

Are you sure about that?

According to the article, the girl had not been to a doctor since she was three (at least she got routine immunizations). Relatives, including an aunt, called the authorities to report that the little girl's life was in danger because her parents were refusing to take her to a hospital and were instead trying to heal her with prayer.

The interesting thing about the case is that, like so many others in the same vein, the legal route of investigation is whether or not the parents were negligent in caring for their daughter. The authorities (and most sensible people) will most likely conclude that not taking a comatose girl to a hospital qualifies as negligence.

The parents, on the other hand, are going to argue that "they did everything they could." They wanted their little girl to live; this was not negligence in the sense that they were unconcerned whether she lived or died. The father attempted to perform CPR. If the family's statements are to be believed, they did not want to see her die.

If the parents truly believe that they did everything they could, one of two things is the case. They were incompetent or they were brainwashed.

I'll leave which one up to the reader to decide.

All About Perspective

This is an older article, but I was digging through "news" archives tonight and I happened to stumble across this little gem.

On July 12, the cancerous growth imbedded in the brain tissue of Warren Lenders got the news no tumor ever wants to hear: chemotherapy. Facing the prospect of cancer-killing radiation, the six-month-old malignant brain tumor could have cursed the heavens for dealing it such a cruel fate. Instead, it chose to be grateful for the time it has left, viewing each new day as a gift from God.

Total brilliance.

The Heart of the Problem

Commenter Bunc on Mike the Mad Biologist's ScienceBlog has succinctly put his finger on the real reason why the whole evolution debate is such an issue. If I may paraphrase:

Part of the problem is that this is seen as atheist evolutionists versus theistic creationists. The fundamental issue is not this--it is scientific literacy versus ignorance.

The reason that many popular versions of theistic philosophy in America are "dangerous" is not because theism is a direct threat--the problem is that many prominent theists, namely American Christians, are fundamentally opposed to naturalistic theories that exclude their god from the creation of mankind (and everything else).

The interesting thing, if you ask me, is that there are well-spoken and intelligent Christians out there who don't have any problems with evolution (or science) and in fact actively promote understanding of it. If you're looking for a breath of fresh air on the subject, I recommend James McGrath's Exploring Our Matrix.

This whole issue cloaks itself as a religious debate--but it isn't. It has nothing to do with theism per se. It has everything to do with promoting ignorance over science.

When Pharmaceuticals Fail, Consider Possession as an Etiology

Bad of The Bad Idea Blog, one of my favorite sites for silly and skepticism, has posted an excellent article about demonic possession and the rising popularity of exorcisms in Europe. I am not ashamed to admit that I nearly fell out of my chair laughing. I'd quote my favorite sections, but that would spoil the article for you. So go read it! Keep yourself amused somehow while I work on part three of the diabetes series PalMD and I are co-blogging about!

Old News: Still Sucks

Laws like these have been getting pitched around a lot lately, mostly in the wake of the Plan B "controversy" perpetuated by people who think they have more right to control what goes on in a woman's uterus than individual women do. And if they can't pass laws making contraception, abortions, or premarital sex illegal, then by God, they're at least going to try to shame everyone on the face of the earth into submission.

And by "everyone on the face of the earth" I mean Americans. Who else is there? I suppose there are those outside-the-box thinkers that are willing to look at the problems of Africa.

Here's what bothers me. It's not that the bill is being discussed, because that's old news. It's not the reality-blind moral paternalism that's associated with these issues. It's the fact that the Indiana Pharmacist's Association is supporting the bill. The priorities of the IPA are clear. They really are the Indiana Pharmacist's Association, because they definitely don't represent patients.

This whole issue hinges on the idea that a pharmacist's sense of moral culpability is going to cause emotional damage to a pharmacist forced to dispense "objectionable products" against their will. That's totally more important than the emotional and financial culpability of an unwanted child. That's what you get for fooling around, I suppose. There's your lesson. There are people--and more frighteningly, health care professionals--who think you deserve to be punished for having sex.

Incoming ad hominem: I am not one bit hesitant to say that those people are inhuman monsters. I suppose it's not really an ad hominem. I'm not saying they're wrong because they're monsters. I'm saying they're monsters after the fact. Move along, no logical fallacies here.

You know, type II diabetes is typically caused by insulin precipitated by obesity. Obesity is commonly caused by overeating, and gluttony is a sin. I think I'm going to stop dispensing metformin, glipizide, Actos, Januvia, Byetta, and every other medication used to treat type II diabetes, because clearly, type II diabetics did it to themselves. They know the risks of unhealthy diets and lack of exercise. They're to blame if they didn't listen. I'll still dispense insulin, though, but only to type I diabetics who can provide the results of lab testing proving that their condition is genetic or autoimmune. Those people are being challenged in the strength of their faith by god, which is why they were created with terrible birth defects.

And no more cholesterol-lowering drugs, either. We all know that diets high in cholesterol are unhealthy, and the most prominent sources of cholesterol in the diet are animal products. The use of animals for food is unethical. If everyone were vegan, we wouldn't need Lipitor. The patients who die of heart attacks due to atherosclerotic occlusions are totally responsible for their own undoing.

I would say something about antidepressants in mockery of Scientology, but that ship has sailed, and they launched it themselves. I hope they didn't waste good champagne.

Come on, people. We've been through the Jehovah's witness scenario a dozen times. Is a JW physician allowed to refuse to give blood transfusions because he believes he's endangering the patient's immortal soul? Don't become a medical professional if you aren't willing to do your job.

Just in Time for New Year's

Somebody linked this comprehensive dissection of the Left Behind "rapture novels" of the late 20th century. I've been reading, engrossed, since last night. There's a lot of interesting stuff here, most of which makes me glad I never read the books.

Quote of the Day

"This is a tool. Like a hammer or a shovel, only a lot more complicated. Just because you don't understand something at first...doesn't mean that it's the magic of the gods." ~Daniel Jackson, Stargate SG-1

Man, science fiction is wonderful.

Oops, I Diverged Into Politics

This is a rarity, but today's Facebook political debate is encouraging.

At the time of posting, 65% of respondants say that a candidates' religious belief should have no role in decision-making. 39,000 people have taken this position, many of them presumably old enough to vote (though Facebook isn't just for college students anymore, it tends to attract a somewhat older demographic than other networking sites due to its roots). 11% of those polled say that faith should have a "strong role" and 24% say that the role of faith should be "balanced with other considerations." As they say, two out of three ain't bad. Approximately 60,000 people have responded. The question is poorly worded if we want to get picky and technical, but I think most readers are going to interpret the question as being about religious faith--belief in the supernatural or divine. Given the predominance of Christianity in America, when most Americans speak of "faith" they're really talking about the Christian faith. The "postmodernist Christian" defense has commonly been to say that science is a form of faith, too, but this is a misguided straw man that shows little to no understanding of the principles of the scientific method. Anyway.

Separation of church and state issues aside, I personally think that faith should play no role whatsoever in decision-making on behalf of other people.

The major problem with using "faith" as a decision-making tool is that it is the ultimate defense. It can be used to justify any action. To question an action that another person has taken because of "faith" is a personal attack; it is impossible to separate the logic used to support the action from the person because ultimately the only reason that the person took the action is because "they felt it was right." Any debator knows immediately that this is an absurdly weak justification and cannot be used to support a position.

This has, historically, been a very bad justification. Americans spread from sea to shining sea because they believed God wanted them to do so. The Bible has been used to condone slavery (Ephesians 6:5-9; do note that that's the NEW Testament). Islamic terrorists, too, have faith that they are doing the will of God. The people behind Global Orgasm are convinced that it's going to heal the world's problems if we all just find time to make love, not war, at the same time (at least this isn't going to hurt anybody, as long as all involved partners are willing). The "yuck reaction," an appeal to emotion sometimes referred to as "the wisdom of repugnance," suggests that anything we feel is icky or wrong must be inherently distasteful, perhaps even against the personified will of the universe. But the yuck reaction has classically been a thin justification for oppression, used by racists, homophobes, and opponents of potentially valuable scientific progress (stem cell research and animal testing come to mind).

As a society, we are taught in America that faith is a personal matter, and it is wrong to belittle others because their faith differs from our own. What this means is that faith is the infalliable trump card for decision-makers in positions of power. It was the will of God, they say. It was manifest destiny. Kings throughout the ages have secured their seats of power by proclaiming themselves to be emissaries or manifestations of the divine. Surely they rule because it is the will of the greatest of deities, and their falls can be attributed to the loss of favor with the same. How can anyone not see the fallacious thinking here? If a man told you he invested in a particular stock because his horse told him to do so, you'd assume he was schizophrenic. Why can a government's leaders use an equally sound defense and get away with it?

If you're in a position of power, you had better be able to back up all of your major decisions with research and strong evidence. It is inexcusable to ignore evidence in favor of "gut feelings." To let faith affect decisions that will impact other people is sloppy and irresponsible; it should not be tolerated.

We have never had an openly atheist President in the United States. An atheist President would not be infallible. Indeed, he or she would be susceptible to the same kinds of potential mistakes that any leader is capable of making. It isn't important to me that our leader be an atheist. What I want is a leader who is a scientist, someone who bases his or her decisions on the hardest evidence available and on verifiable data instead of ethereal whispers and tomes so far removed from context as to be nearly useless for governing modern societies.

I'm willing to give the 24% who say faith and "other things" should be considered equally the benefit of the doubt because there are quite a few people who don't seem to realize that your personal feelings can be divorced from available evidence when making decisions. When you are governing a million people, sometimes the best decision for the masses is not the one you personally like the most. We don't have a direct democracy in America; we live in a republic. We elect our representatives to make decisions regarding what is best for all of us. Can't they have the maturity to set aside their personal feelings when drafting bills or voting on movements? Why are so few people able to divorce ideas from their sources and consider the ideas without letting the source bias their reasoning?

Vatican Declares Creationism = Paganism

Holy fundie-repellant Bat-spray, Robin! Ker-POW! Wham! BIFF!

Take that, ID!

I Really Wish...

I could post something that was good news, because right now I'm breaking into the blogosphere with a crash of pessimistic thunder and accompanied by an armada of dark storm clouds.

Unfortunately, I hope you brought your umbrella, because a federal judge just suspended a state law requiring pharmacists to dispense emergency contraception, otherwise known as "Plan B." According to the article, the law unconstitutionally violates pharmacist's freedom of religion:

The rules appear to force pharmacists to choose between their own religious beliefs and their livelihood, Judge Ronald B. Leighton of the U.S. District Court in Tacoma wrote Thursday.

Some pharmacists believe the emergency contraceptive pills, also called "morning-after pills," are tantamount to abortion because they can in some cases prevent implantation of a fertilized egg.

"Whether or not Plan B ... terminates a pregnancy, to those who believe that life begins at conception, the drug is designed to terminate a life," the judge wrote in a 27-page order granting a preliminary injunction.

As a little background, Plan B consists of a package containing two 0.75 mg tablets of levonorgestrel, a form of progesterone. One tablet is intended to be taken as soon as possible, with the second tablet following 12 hours later. The sooner the first dose is taken, the better; this is a drug where time is crucial. Because Plan B is now available "over the counter," it may be true that if one pharmacist refuses to dispense the drug that the patient can simply go to another pharmacy. But what kind of option is that? Every minute counts. And isn't it possible that every pharmacist within reasonable distance of your home might refuse you EC just because they don't think you should be permitted to have it?

It doesn't help that few people actually understand the science behind Plan B, even pharmacists. 25% of pharmacists surveyed in North Carolina thought Plan B was an abortion pill like mifepristone (RU-486), which will actually terminate an early-term pregnancy. 5% who knew that it wasn't RU-486 still thought it could somehow directly induce an abortion. They've apparently forgotten their physiology; part of the way that the body maintains pregnancy is jacking up serum progestins to keep the endometrium from sloughing off and dumping out an implanted fetus with the next menstrual load. No wonder they're opposed to it; they have no idea how it works! In fact, RU-486 works because it's an synthetic anti-progestin steroid. And it's commonly cited that Plan B works by preventing implantation, which is only partly true; like other oral contraceptives, Plan B also alters cervical mucus and the action of the fallopian tubes. It may even prevent ovulation entirely, depending on where the woman taking it is in her cycle! It may, in many cases, prevent union of sperm and egg altogether. Even if it didn't, refusal to dispense EC but dispensing other oral contraception is logically inconsistent. They have identical mechanisms of action.

Think about it this way. Suppose you were seriously injured and losing large amounts of blood. You desperately need a blood transfusion. The attending physician at the ED appraises your condition and shakes his head. "This patient is bleeding to death," he says to his colleague, "but there's nothing we can do. It's for his own good that we not save his life. I won't be responsible for condemning his immortal soul."

Sound impossible? Maybe. But a woman recently died during delivery of twin babies for refusing a blood transfusion. She was a Jehova's Witness, and her religious beliefs prevented her from recieving blood transfusions. It is common legal and ethical precedent that physicians cannot treat patients without their consent. And a doctor who refused to treat patients on the basis of his or her religious beliefs could potentially be sued for malpractice. Why can't the same be done for a pharmacist? Pharmacists have been sued over this issue in the past; why in the world would a court overturn that ruling now?

Perhaps the issue is one of urgency. Any layman can tell you that severe hemorrhage is potentially fatal, and very quickly so. But what about symptomatic iron-deficiency anemias? Treatment protocol for patients experiencing significant shortness of breath or other potentially serious problems includes an infusion of red cells. Can you imagine a doctor telling a patient, "it's okay, just take iron supplements for the next month, eventually you'll get better without a blood transfusion?" It might potentially be true, but does that mean it's good medicine? It's vastly subpar care with no medical basis or scientific evidence to back it.

The article mentions that most people "can get Plan B without a pharmacist," but as I understand the matter, that's an issue of state law as well. Where I work, a patient must present an ID to purchase Plan B, and all sales must ultimately go through the pharmacist. If the pharmacist refuses to sell Plan B and finds out that a technician has violated this decision, the technician could very easily be fired. How many technicians will risk their jobs like this?

In summation, I really have to agree with one of the activists quoted by the article:

"I think this is another step on the assault on women's rights to control our own bodies," said Helen Gilbert, an activist with the group Radical Women. "If [pharmacists'] beliefs are in conflict with doing this job, then they should do a different job." [Emphasis mine.]

Absolutely. To quote a pharmacist I used to work with, refusing to dispense oral contraceptives or emergency contraception is like a Christian Scientist getting a medical degree and then refusing to treat anyone except with prayer. Why would you take the job if you find it incompatible with your belief system? You are responsible for certain things as a medical professional. If you don't like them, find another line of work.