the tensions inherent in public health law

The November/December resolution throws light on a growing area of legal interest: public health. In "Mapping the Scope and Opportunities for Public Health Law in Liberal Democracies," found in The Journal of Law, Medicine, and Ethics, Winter 2007, Roger Magnusson, a law professor at the University of Sydney, notes (among other things) the tensions in contemporary public health law.

The first, as always, is the tension between proper government action and individual rights:

Lawrence Gostin points out that the protection of the public's health is necessarily a public function that should also be regarded as a duty of government. Discharge of that duty carries "intrinsic and instrumental value for individuals, communities, and entire nations." At the same time, public health law is that body of law which - in a liberal democracy - keeps the state on a short leash, and there is considerable resistance to lengthening it. At the same time, in one of many contradictions in American law, Nan Hunter argues that this is precisely what is occurring as public health and national security have moved closer together to meet the threat of bioterrorism and pandemic influenza.

The "national security" angle is one that affirmatives should explore. The resolution doesn't specify who would be receiving compulsory immunizations; the Negative, presumably, would have to defend the right of medical workers and soldiers (among others) to refuse immunization, even in a crisis.

However, an important Negative consideration is the tension between wider and narrower conceptions of just what constitutes "public health concerns"--and the propensity for the debate to expand into the international arena.

The health and human rights movement provides a further example of public health law expanding to embrace, in this case, global human rights norms and laws, exploring the potential for the promotion or neglect of global norms to enhance or harm the health of populations. The usual criticisms of these approaches is that they turn "life, the universe and everything" into a subdivision of health. In Mark Rothstein's words, "just because war, crime, hunger, poverty, illiteracy, homelessness and human rights abuses interfere with the health of individuals and population does not mean that eliminating these conditions is part of the mission of public health."

The effect of such a broad definition is not only to increase government overreach, but to insulate the government from criticism, since "public health" is a powerful way to frame policies that might otherwise be seen as the normal risks of everyday life, accepted in a free society. Furthermore, globalization puts the drafting and enacting of such policies out of the reach of citizens within any given nation. Thus, from a social contract perspective, a widening "public health" definition is doubly a menace to individual rights and governmental legitimacy.

tax facts, Washington state edition

http://www.stateline.org/live/details/story?contentId=430433 [via TaxProf Blog]

saved by the stimulus, or adventures in accounting

How has the stimulus affected public education?

Teachers appear to have benefited most from the effort to save jobs with the $787 billion recovery package, which sent billions of dollars to states that were on the verge of ordering heavy layoffs in education.

The national data on the impact of President Barack Obama's stimulus plan won't be available until later this month. But based on preliminary information obtained by The Associated Press from a handful of states, the stimulus spared tens of thousands of teachers from losing their jobs.

Not surprising. We saw this very scenario play out here in the Olympia School District earlier this year. A potentially heartbreaking RIF was avoided in large part due to a sudden influx of federal cash, mostly averting--or, perhaps more accurately, delaying--a crisis.

But the article is also a commentary on the government's new attempt to bring transparency to the doling-out process. The brutal honesty quote:

The White House says more than 1 million jobs have been saved or created so far, a figure that is so murky it can never be verified. That's because the White House estimate is based on economic models that try to calculate the effect of tax cuts and the ripple effect of government spending.

And the good news/bad news quote:

Officials have said the unprecedented accounting could become standard for government programs in the future, and this week's data release will offer the first indication of how it's working.

The good news: translucency bordering on transparency. The bad news: somehow this is a new idea.

the ugliest ugly building

No matter how aesthetically atrocious Olympia's Ugly Building is, repeat to yourself: it's no Portland Building. It's no Portland Building.

today's vaccination links

The Nov/Dec LD resolution, "Resolved: Public health concerns justify compulsory immunization," couldn't be more topical.

You're all over the CDC's website, right?

Swine flu vaccines are ready. But not everybody wants one--for themselves, or for their kids.

How distrust of swine flu vaccine unites right and left.

It doesn't help when journalists get the facts very, very wrong.

Something to think about: let's say smoking is a public health concern. Does that justify compulsory anti-smoking vaccinations?

value / criterion pairs for the immunization resolution

LD casewriters studying the November/December compulsory immunization resolution might consider the following value and criterion pairs. (Have your own ideas? Suggest them in the comments!)

See also: my guide to some useful philosophers, plus a way to consider the criterion in LD debate.

A work in progress.

V: Societal Welfare
C: Act or Rule Utilitarianism
As I've mentioned elsewhere, many affirmative cases will use either explicit or implicit utilitarian reasoning. It's easy to figure out why: compulsory immunization, from the state's perspective, violates autonomy in order to keep the herd immune, and reduce suffering and death. Of course, some may argue that Mill's nonpaternalistic utilitarian scheme, via the harm principle, supports the negative, but that's what makes it fun.

Note: a potentially fruitful line of argument might be an analogy based on the infamous Trolley Problem. Also, see here for a deeper look at utilitarianism as a moral criterion.


V: Governmental Legitimacy
C: Social Contract
Because the resolution concerns compulsory immunization, making the agent of action the State, social contract theory comes into play. Change your value to "societal welfare," and you can make arguments based on contractarian reasoning as well. (My initial thought is that Hobbes or Rousseau are your best bets here.)


V: Freedom
C: Reducing Biopower
Foucault, anyone?


V: Autonomy
C: Deliberation
Without autonomy, humans are slaves, robots, or worse. Autonomy is the core of human freedom, rights, and responsibilities. Compulsion is a direct affront to autonomy; deliberation (especially deliberative democracy) uses dialogue and education to create change. (As you can probably see, this is a Negative approach.) Potential philosophers: Arendt or Habermas.


V: Autonomy or Humanity
C: Kant's Categorical Imperative
The Neg might argue that compelling someone to take a (potentially risky) vaccine in order to protect the herd is a classic case of using someone as a mere means to an end. If so, Kant says no.


V: Life
C: Utilitarianism
A fairly straightforward setup.


V: Justice
C: Rawls' "Original Position" or "Veil of Ignorance"
Compulsion is always a matter of justice. But with competing rights claims--and competing visions of the right--how can societies agree on what justice means? John Rawls' "veil of ignorance" offers an interesting form of a moral criterion, especially given Rawls' biography. Does compulsory immunization in the service of public health meet this standard?


V: Societal Welfare or Life
C: Negative Utility


V:
C:

stretching the truth; sketching a lie

A clever little experiment was recently designed to determine whether liars could be discovered through drawing. How it turned out:

While many of the liars gave convincing verbal accounts to the agents, when their drawings were compared with those of truth-tellers, there were features that distinguished them (Applied Cognitive Psychology, DOI: 10.1002/acp.1627).

The first was who they drew: 2 out of 16 liars included the first agent in their drawing, whereas 12 out of 15 of the truth-tellers included that detail. Vrij suggests this is because the liars visualised a place they knew and simply drew this, neglecting to include the agent.

The second difference was perspective, with liars tending to draw the laptop handover from a bird's-eye perspective rather than a first-person one. Vrij suggests that while liars are adept at quickly coming up with a plausible verbal account, they find imagining spatial relationships between conjured-up objects more difficult from a first person perspective.

The technique isn't perfect, but as a supplement to existing interrogation techniques, it seems pretty useful. (And anything's got to be better than a polygraph.)

Of course, you can arrest veryone who asks if they can just draw stick figures. They're bound to be guilty of something.

what puzzles psychologists

When they're not helping you solve your (manifold) problems, what are they puzzling over?

The email edition of the British Psychological Society's Research Digest has reached the milestone of its 150th issue. That's over 900 quality, peer-reviewed psychology journal articles digested since 2003. To mark the occasion, the Digest editor has invited some of the world's leading psychologists to look inwards and share, in 150 words, one nagging thing they still don't understand about themselves. Their responses are by turns candid, witty and thought-provoking.

And, in the spirit of blogging, brief. Check 'em out.

[via Mark Frauenfelder]

definitions in the compulsory immunization resolution

The November / December NFL Lincoln-Douglas debate resolution...

Resolved: Public health concerns justify compulsory immunization.

...offers some interesting definitional possibilities.

(Unless otherwise noted, definitions from Dictionary.com, which uses the Random House Unabridged Dictionary.)

Public health
"Health services to improve and protect community health, esp. sanitation, immunization, and preventive medicine."
Note the largely preventive nature of public health. Immunization is meant to prevent unnecessary sickness, suffering, and death. Note also that the word "public" is important. The agent of action in this resolution is the government, which brings social contract reasoning into play.

Concerns
"something that relates or pertains to a person; business; affair"
"a matter that engages a person's attention, interest, or care, or that affects a person's welfare or happiness"
This is a particularly prickly word for the affirmative. Although "concern" carries a connotation of anxiety or worry, negatives might argue that the term is vague, and (as a general principle) doesn't rise to the level, say, of an emergency. Affirmatives would do well to combine the above definition of "public health" with the first definition of "concern"--arguing that the very business of "public health" is that of prevention through, among other things, immunization. (Also, they should point out that governments rarely compel trivial immunizations, trying to block out negative arguments about wholesale rights-trampling.

Justify
The two major senses of justification may lead to completely different kinds of arguments. Those (especially on the negative) defining the argument in terms of rights will use the first sense: "to show (an act, claim, statement, etc.) to be just or right."

Those advocating a utilitarian approach might use the second definition: "to defend or uphold as warranted or well-grounded." This is much, much broader, and works with a wide array of criteria, including cost-benefit analyses.

Compulsory immunization
The resolution offers no bright line for how immunizations might be compelled: through fines or taxes? Through force? Affirmatives will want to look at the history of compulsory immunization for examples of how governments usually go about it.

Note: a phrase that isn't found in the resolution, but is critical for both sides to understand, is "herd immunity"--the idea that when enough members of a community are resistant to infection, it will effectively disappear in a population, protecting even those members (like conscientious objectors) who refuse to be vaccinated. The threshold is usually above 80%. The aff will argue that, historically, reaching the threshold has required government meddling, if not outright compulsion.

step away from the candy bowl

Jason Kuznicki on the semiotics and politics of office candy:

There were the little rituals. You’d come in, take a piece of candy, start a conversation, do business. But some people would wait until your office was empty, then sneak in without so much as turning on the light. Some of those people got caught. I was once told by a Hershey’s-Miniatures woman that the visitors dropped off when the Special Darks ran out. Once she realized it, she stopped offering an assortment. The visitors came back.

When you wanted candy without a conversation, you’d have to feign a certain socially appropriate amount of guilt. And the owner of the office would feign a certain socially appropriate amount of judgment. A slight wince; a raised eyebrow. And then: chocolate! So worth it.

Your smile may be wide, your handshake firm. But if your candy dish is suspect, so are you.

Oh, and keeping candy in sight, as Kuznicki's later anecdotal observation confirms, is scientifically proven to increase consumption.

Mmm. Candy.

throw more curveballs

Steven Levitt and Ken Kovash claim that pitchers, among other athletes, are too predictable:

They first analysed over 3 million pitches thrown in major-league baseball games between 2002 and 2006. For each type of pitch, they measured the batter's "OPS" – a number that represents how likely a batter is to reach a base or to make a big hit. They found, on average, that fastballs tended to give batters 20 per cent higher OPS than curveballs.

If pitchers played according to minimax, the OPS for curveballs and fastballs should be the same, but in fact pitchers gave batters a slight edge by throwing too many fastballs.

Levitt and Kovash then looked at whether or not pitchers chose their pitches as unpredictably as minimax theory says they should. They found that when a pitcher threw a fastball, his next pitch was 4 per cent less likely to be a fastball as well. If pitchers played truly rationally, there would be no such bias towards switching the type of pitch. "Pitchers are being just a little too cute on the mound when they're switching back and forth so often," says Kovash.

Read the entire thing for the (predictable) caveats and nay-saying. OPS isn't the be-all end-all of baseball stats, for one.

I wonder how a pitcher who dialed up pitches totally randomly would fare in the bigs. It could be pretty interesting: randomness means the possibility of, say, throwing five fastballs in a row, then a curve, then four more fastballs. There'd be no such thing as a "fastball count," and a batter who thought that a curveball was "due" would fall prey to the gambler's fallacy.

Resolved: Public health concerns justify compulsory immunization .

Update: The November/December Lincoln-Douglas debate resolution has been released:

Resolved: Public health concerns justify compulsory immunization.

Scientists and public health officials get frustrated, even angry, by vaccine dissenters, a small, but increasingly vocal minority. After all, the argument runs, vaccinations have undoubtedly saved millions of lives since their inception. The risks are minimal; the benefits massive. Besides, without compulsion--without the greatest possible protection of the population--those benefits aren't seen.

So, from an LD perspective, how might we approach the resolution?

Affirmatives will probably use broad-based utilitarian reasoning. If, on balance, compulsory vaccination saves more lives than it puts at risk, then the decision, societally speaking, is a no-brainer. Assemble a few statistics and expert quotes, value "life" and set your criterion to utility, and let logic do the work.

Negatives could respond by attacking the stats, or taking a more philosophical approach, citing the John Stuart Mill adage that "Over himself, over his own body and mind, the individual is sovereign." This is the classic argument against inoculation; go back to the 1907 anti-immunization book Vaccination by John Pitcairn to see an example.

The rejoinder to this sort of argument is to quote Mill against Mill, as the Washington State Board of Health does in this vaccination briefing [pdf].

John Stuart Mill in On Liberty wrote that “The only purpose for which power can rightfully be exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.” This thesis has become known as the harm principle. The Immunization Advisory Committee endorsed the harm principle and interpreted it to mean that vaccine mandates are justifiable when without them:
• An individual’s decision could place others health in jeopardy
• The state’s economic interests could be threatened by the costs of care for vaccine preventable illness, related disability or death and for the cost of managing vaccine preventable disease outbreaks
• The state’s duty of educating children could be compromised

The crucial thing about communicable disease is that it requires no agency on the part of its victims. Innocents are vectors, too.

Since the recipients of vaccinations are most often children, the persons being harmed--or at least risking harm--aren't legally able to accept or refuse inoculation on their own. As the briefing shows, this adds an "it takes a village to raise a (healthy) child" dimension to the debate.

Returning to Pitcairn, at the close of his book, a diatribe against "man-made science" interfering with "God's handiwork" points to another classic argument: that vaccination tampers in God's domain. Updating this logic for the evolutionary era, some anti-vaccinationists will argue that inoculations destroy natural immunities or upset nature's balance. (Want to really go crazy here? Open to a page from the policy playbook, and argue that vaccination is responsible for overpopulation and its concomitant harms. Just don't be surprised if your judge finds you scary.)

Lastly, the Board's briefing cited above refers to allowable exemptions for religious reasons, another argument both sides must prepare for.

For a backgrounder, Wikipedia's page on anti-vaccination arguments is a great place to start. I also like Douglas Diekema's accessible intro to the ethical debate [pdf].

Added: An example of the practical effects of the contemporary debate on vaccination.

Added 10/1: For an accessible introduction to the vaccination controversy from a pediatrician's perspective, I highly recommend Jamie Loehr's The Vaccine Answer Book. It's clearly organized, scientifically minded, and humane.

Added 10/4: I survey some critical definitions.

Added 10/11: An initial list of value/criterion pairs.

Added 10/12: Some thought-provoking links, and a critical question. What if they had a vaccine for smoking cessation? Would public health concerns--which in the modern day certainly include smoking--justify compulsory anti-smoking vaccination?

Added 10/16: How far does the logic of immunization stretch? One blogger considers Gardasil as a paradigm for the question.

And read this NewScientist article on the potential for a "universal flu vaccine."

Added 10/18: An article discussing the tensions in public health law, with implications for the resolution.

Added 10/21: Two parents talk about why they're in favor of vaccination. Hint: it's for the children.

Added 10/22: Why public health law threatens us with "medicalized tyranny."

Added 10/25: Some lines of argument for the affirmative.

Added 11/14: An open thread: what good/bad arguments did you face this weekend?

Added 11/22: In which I tackle the dubious 98.5% statistic.

Added 11/24: The Siracusa Principles as a criterion for the Neg.

Added 12/7: The future brings us... personalized vaccines?

More links and analysis to follow. Add your questions and thoughts in the comments. (This post was updated and edited from a preview written during the summer.)

Obama plans to ruin your summer vacation

Kids who creepily sang Obama's praises the other day: might want to rethink that. Obama wants to amputate your summer break.

"Now, I know longer school days and school years are not wildly popular ideas," the president said earlier this year. "Not with Malia and Sasha, not in my family, and probably not in yours. But the challenges of a new century demand more time in the classroom."

The president, who has a sixth-grader and a third-grader, wants schools to add time to classes, to stay open late and to let kids in on weekends so they have a safe place to go.

Just give the plan a snappy title--No Child Left Outside?--and watch it sail through Congress.

In all seriousness, reconfiguring the summer break is way, way overdue.

Capital to rejoin Narrows League?

It appears that Capital, along with the three other remaining teams from the tiny Western Cascade Conference (itself part of the WCC/OWL--confused yet?), will rejoin the Narrows League next year.

The Narrows League will absorb the four remaining Western Cascade Conference teams: North Thurston, Timberline, Yelm and Capital, all Class 3A teams.

That will make the Narrows League, which was founded in 1979, as a 15-team league.

The Narrows League had previously been resistant to adding Class 3A teams. Several Tacoma schools could end up in the 3A classification next year as they were “opting up” to remain in the Narrows League. Gig Harbor had 3A numbers as well and opted up.

A committee will meet next week to being figuring out how this re-configured league will look and function.

My guess is it'll have two subdivisions, hopefully based on geography to make travel and gate proceeds best for all involved.

At least two good things about this, from Capital's perspective: first, playing in a bigger league means more battle-testing before the playoffs. Second, it restores the full import of the traditional crosstown rivalry with Olympia--now the game would matter for more than pride.

Capital's proven that it can hang with 4A schools. Next year, we'll have to do more: we'll have to beat them.

[via Meg Wochnick]

the day the cell phone died

Via Cory Doctorow, a clever little video highlighting the cell phone failures that angst up the modern thriller. (Warning: salty language and excessive horror cheesiness.)

There's an element of verisimilitude to the cliché; in the summer of '08 my wife and I found ourselves stranded in the Olympic mountains, no cell signal. And there's nothing more frightening than mountains.

the cruelest blackout

In my swine flu funk, I'm sitting on the sofa, watching ESPN360, as USC (the other USC) takes on Ole Miss. During commercial, the site jumps over to ESPN radio, displaying a list of upcoming games and TV blackout maps.

This one cracked me up:



For the upcoming, certain-to-be-a-barnstormer contest between Idaho's Vandals and the Northern Illinois Huskies, ESPN360 has blacked out the roughly eight counties that might care about the game. (And not one is in Idaho.)

Nice work, ESPN.

is this swine flu?

I'm sitting at home, congested, sore-throatish, achy. Most important: I am at home. I am not teaching today. I'm keeping my germs in the family.

I have my principal's permission. Via email:

We are experiencing several students coming to the health room with flu-like symptoms and we are sending them home.

The health department asks that students who have a fever be kept home for 24 hours after the fever has subsided without the aid of medication. (like Tylenol or Advil)...

In addition, even though educators hesitate to miss school, even when sick, we would like teachers to make sure that you have sub plans on file, stay home if you are ill and follow the same 24 hour fever free rule. Please do not come to school to bring in sub plans, but phone a colleague or email them to us. It is important that we also look out for our staff.

Last night's fever was mild-to-medium, and this morning's congestion was medium-to-spicy.

Perhaps it's swine flu, or perhaps it's just a nasty rhinovirus. Either way, I'm sitting at home.

"chicken one day, feathers the next"

The concretion, found in Oregon, offers a potential glimpse into a world millions of years in the past, but the story offers an equally fascinating glimpse into the colorful world of paleontology.

"It's kind of like your first blind date," said state paleontologist Bill Orr. "The closer they get, the worse they look...."

We're waiting for Mother Nature to knock it off the wall," Hanshumaker said.

There's an expression in paleontology, Orr said, that describes the frustration involved in finding something that might be spectacular but really isn't that big of a deal.

"Chicken one day, feathers the next," he said. "This is definitely a feather day."

Here's hoping for a really cool chicken ancestor trapped in the middle of an ancient rock.

it's called "projection."

Daniel Mallory in high dudgeon, takes on the Onion's AV Club:

Nominally non-satirical, the section aims to commune with Onion readers, who in turn could easily mistake its crueler-than-thou hipster solipsism for parody. A few pop-culture artifacts (the Magnetic Fields, "Arrested Development," those fauxteurs Terry Gilliam and Wes Anderson) send the A.V. writers cartwheeling, but for the most part they traffic in snark -- which, as David Denby observes in his book "Snark," "has zero interest in anything except the power to ridicule." Consider the diverse bureaus of the A.V. Club: the Hater blog, devoted to further exposing celebrities it decries as overexposed; I Watched This on Purpose, a masochistic catalogue of crimes against film; the Tolerability Index, which gauges "what we're barely putting up with this week" (exempting, of course, its own tone of entitled contempt). Acrid stuff.

As AV Club writer (and link source) Scott Tobias notes, this is cherry-picking of the worst order. AV Club writers are snarky at times, to be sure--their parent site is a satirical newspaper, fergoodnesssake--but if they are harsh toward pop culture's trash, it is because they so love pop culture's treasures.

Consider just two of the site's features Mallory ignores: Primer and Gateways to Geekery, whose very purpose is to open up new alleys for pop culture neophytes to explore. The site is often brutally honest about its own failings, a trait uncommon to critics. And no one gets a free pass; in its (loving) TIFF wrapup, supposed "fauxteur" Gilliam earns a D+.

I won't comment on the rest of Mallory's piece, which concerns a memoir I haven't read, except to say that for someone who deplores acridity, his criticism sure packs a sting.

And I'm not sure what stage of life involves defending a pop culture website. But it seems like a good stage.

grades are arbitrary?!!

Yep.

A "D" average is good enough to earn a diploma, according to the Seattle Public Schools.

The district is considering dropping graduation standards from a "C" average to a "D" average in order to boost the number of college-ready students.

The school board is doing its own math on the district's logic.

According to an administrator, the district wants to offer more advanced classes and raise the bar. In order to do so, it needs money. To get that money, it has to find a way to keep more kids in school. So a "D" might be good enough to graduate.

What does a "D" mean?

Some places, you pass with a C. Others, you pass with a D. Some places, a C starts at 70. Other places, a C starts at 62.

Yep. Grades are arbitrary.

Which is what makes arguments over changing grading schemes so much fun.