Bay 12 Games Forum

A complete issue of the BMJ's Journal of Medical Ethics dedicated to the topic last year. Much of it's behind a pay wall but as with nearly any academic article free mirrors can usually be found with relative ease.

Positions that are ethically open-and-shut except for financial interests don't get full issue debates in significant medical ethics journals.

Particularly ridiculous is that both the "meta-study" people and all the African researchers from 10 years ago, despite heralding the wonders of circumcision STD prevention all still tell you to use condoms anyway, which by themselves are almost completely protective when used correctly. So basically, if you want complete protection, your options are:

A) Use a condom, or
B) Cut off part of your dick, which contains the majority of its nerve endings. Then use a condom anyway.

Hmmm  that's a tough one.

I remember the original studies. The effect was hugely significant, regardless of condom use (reported as similar between the two groups). At least one early study was abandoned after the original effect size was so significant that it was deemed unethical not to expand the treatment (circumcision) to the control group as well.

Now the actual effect/effect size has been called into question and there has never been a satisfying mechanism for prevention (which I have seen at least), which suggests it shouldn't be trusted and certainly never could be considered a replacement for condoms even if it works. But pretending that it wasn't honest research or an actual measured effect because they recommended use of condoms doesn't make sense.

Ridicule is not a substitute for understanding.

I think the example of circumcision is far from as clear cut as it is being presented. While I don't support it in any way, I don't think it is an obvious case of financial gain overruling medical ethics.

The 2004 BMA ethic guidance noted that;

There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral, or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself. The medical harms or benefits have not been unequivocally proved except to the extent that there are clear risks of harm if the procedure is done inexpertly. The Association has no policy on these issues. Indeed, it would be difficult to formulate a policy in the absence of unambiguously clear and consistent medical data on the implications of the intervention. As a general rule, however, the BMA believes that parents should be entitled to make choices about how best to promote their children’s interests, and it is for society to decide what limits should be imposed on parental choices. What those limits currently are is discussed below, together with the legal and ethical considerations for doctors asked to perform non-therapeutic circumcision.

The BMA ethics committees are hardly financial interest groups. I'd say their guidance, if old there, is accurate to the perspective on circumcision by most medical practitioners.

The question of medical benefits and harms crops up in the literature every few years, most famously the AIDS prevention stories. WebMD still lists more medical benefits than risks to the procedure. Whether these benefits hold up - or if they can justify non-voluntary circumcision of babies - is a debate I think is valid and important, but not one that is so clear cut that a blanket ban on the procedure for Hippocratic reasons is obvious and inherent. Especially when you take into account the cultural and social factors, not least preventing non-expert circumcisions by refusing and having it done by untrained practitioners.



I'd also note that most people are really bad at researching things. I'm often shocked by people with university educations failing to do a cursory search beyond that one amusing article their friend linked on Facebook to check the validity of a story or article. Actually digging into primary evidence is way beyond most people, at least in the time investment they are willing/able to make and their ability to assess such information. Tertiary resources that most people rely on are easily biased or selective about the points they present, swaying people to their own viewpoints (so often themselves financially or ideologically motivated).

The most obvious examples here would be climate change (even with reports like the IPCC making a point of summarising and presenting evidence on a politician's level) and anti-vaccination bullshit. But even for not obviously politicised medical treatments you get a lot of nonsense out there that people can absurdly lock onto.

And all too often the idea that something is financially profitable therefore evil is the key argument to a lot of that bullshit. Take the industry of alternative cancer cures. They argue that proven (if unpleasant and often desperate) treatments like chemo- and radio-therapy are pure evil designed to keep people sick for the profit of medical practitioners. They know the secret to treating cancer, which usually involves some pseudo-science and a few thousand dollars invested in their own miracle cure based on pre-germ theory medical science. Or the alt-med push for vitamins to cure everything, if you only ignore what the drug companies say about medical treatment. Just buy these vitamin pills (pumped out in the downtime on GlaxoSmithKline and relabelled) and ignore the doctors. They are obviously just financially motivated...

Might be a big implosion going on right now.

Alt-Fest got funded last year. Only  £61,762 (£30,000 goal) of what appears to have been seed cash to develop a multi-genre, alternative based (primarily goth) festival. They managed to put together an incredibly impressive lineup, a rather interesting philosophy and ethos behind the event and fairly reasonable prices for this sort of thing.

And today there are rumours of it all being cancelled, 16 days out for it opening.

A bunch of odd emails and stories popped up a few hours ago, now two of the big headliners (Marilyn Manson and Cradle of Filth) have events showing as cancelled. There are broken websites and rumours of emails being sent by guys who were fired, some bands being contacted directly, others indirectly through management, others not at all. Rumours of one stage being pulled, rumours of health and safety issues with the site. Rumours of a £400,000 shortfall of cash. No official statement at all from the festival organisers.

I wasn't in on the kickstarter but got a cheap earlybird ticket through a friend. Was going to be the only big festival I did this year. Probably end up just being a Damnation year again...

Here's my question; are people seriously arguing that Israel targeted the UN school to... what? Kill refugees and aid workers? Destroy any international goodwill they might have had left?

The idea that Israel would make a deliberate strike just to kill people in such a manner is absurd. That's not to say that it couldn't have been an Israeli strike, but the idea that they are deliberately slaughtering people just to slaughter them makes absolutely zero sense, as well has having some unpleasant history in this area.

A think tank set up to study income inequality deliberately sought out conservatives to contribute. They couldn't get any.

No conservative economists applied for grants, among the 70 submissions the center received, Boushey said. Perhaps that’s because the center has, in its early months of existence, engaged in some high-profile blog-and-social-media fights with conservatives over questions of data and policy when it comes to inequality. Perhaps it’s because it’s relatively rare in Washington for liberal and conservative thinkers to team up to pursue big questions – especially ones that, depending on the answer, could shake party platforms or basic ideological beliefs.

It’s also true, in this case, that a lot of conservative economists have already decided that inequality – as opposed to mobility or the even broader “economic opportunity” – isn’t a problem.

This is the real challenge posed faced by Boushey, and her center, and the work that will now begin thanks to their grants: If most of the research into an economic issue is being conducted from one side of a political debate, consumers of that research could – and should – look skeptically on its conclusions, until persuaded otherwise. The burden is on the researchers, on their data and the stories they tell from it.

It’s a heavy burden. It would help to have a more diverse group of thinkers shouldering it.

In other academic economics news, a group created a metric for CEO performance and compared it to CEO pay.

I'm on my phone now so can't pull up the link, but if you look at the UN's own condemnation of the rockets being stored in the school they state it is a building between two other large, used schools with thousands of civilians in them. At the same time the whole compound is a UN secured zone, supposedly a safe haven for refugees. Nitpicking over whether that particular building was in use is just that. It's scoring internet debate points over actually establishing facts.

As for the rest, a quick google gives you the IDF's footage of rockets being fired from hospitals and discovered in other schools. There have also been articles about journalists being attacked online for tweeting about rockets fired from around hotels, hospitals and similar. Not to mention the famous image of a hospital being used as a Hamas media centre (with historical claims it has been a military command centre for years). I know you won't accept/trust most of those, but they exist and are trivially easy to find.

It is clear that Israeli are better protected by the state doing everything to keep the situation at state 1 (Unless there is a possibility that military actions, while causing state 2 for a while will eventually lead to a state 3 of long-lasting peace).

The switch to state 2 was before the ground offensive. Hell, before the air strikes. You can argue the government's actions helped lead to these events, especially with regards to their treatment of the kidnapping case, but the primary trigger was non-state actors. Which is one of the main problems; you have too many parties who can break the status-quo for it to be comfortable or acceptable long term for Israel. Like I said later, I see the current ground push as a desperate attempt to find a temporary state 3, as in the past.

Regarding an occupation, I don't think Israel will be able to significantly degrade Hamas' capabilities. My guess is that at some point, Israel will declare victory, pull back, and leave a strengthened Hamas (They will boast of having pushed back an invasion) at the cost of a large number of Israeli lives and diminished international standing. Basically, the Vietnam scenario.

I think they will weaken Hamas somewhat militarily, it's a question of how much logistical damage (tunnel network) they can deal and how many political gains Hamas make in the meantime. A lot of that is going to come down to the PR war as well.

"Spying is not an option, because that would be a presence in the strip and would piss them off!"
"Oh okay, what are you going to do instead then?"
"Oh, not much. We're gonna send in a bunch of tanks and bomb the shit out of them."

...Just stop and think about that for a second, dude.

You are comparing two very different things here.

Israeli operations within Gaza would be justification for Hamas to conduct military operations against Israel, similar to those that triggered this sort of offensive in the first place.

There are basically two states at the moment the conflict takes on the Gazan side;

1) Low level rockets attacks from non-Hamas or deniable forces, along with tunnel preparations and maybe isolated tunnel attacks.
2) Full scale, Hamas conducted rocket launches and the use of the complete tunnel network to conduct attacks whenever possible.

Your policy is that state 1 should be accepted by Israel, maybe with limited countermeasures. My point was that some of your proposed countermeasures would be enough to trigger a switch to state 2. Combine this with Hamas having access to better resources (a lifting the blockade) and you have a situation that Israel could never accept.

In your opinion. As it turns out, most of the nations in the UN human rights council disagree with you. As do I. Dunno what else to say to you if you're going to disagree on as fundamental of a level as "innocent lives are equally valuable"

In my opinion a government that takes action that will knowingly let it's own civilians die from an enemy military action is a government that has lost all moral authority. One of the core purposes of government is the national defence. Abandoning that purpose means the government has abandoned it's core purpose and should be replaced.

It's not saying that they should be free to kill as many people they are able to for that purpose, but that taking a policy approach that doesn't attempt to stop citizen deaths is a morally unacceptable position for any government.

Fair enough. But your article also includes:

Quote

By the end of 2010, [Egypt] claimed to have sabotaged some six hundred tunnels by various means, including plugging entrances with solid waste, sand, or explosives, and flooding passages with sewage. Use of tear gas and other crowd-control techniques inside the tunnels resulted in several deaths.

Even if I might be underestimating, you're OVERestimating their sophistication, invulnerability, and invisibility.

You ignored the part where it noted that they only took the oldest, most obvious tunnels, ignoring the more used and sophisticated ones. It's also talking about long term, smuggling tunnels, not ones that were kept concealed until immediately before a militant attack.


You seem to be trying to play gotcha with arguments and phrasing rather than actually trying to understand the conflict and situation any better. I've been trying to make you engage on a level a bit deeper than blanket condemnations of Israel.


The war crime stuff... I don't think there's any point continuing with that discussion. You have comprehensively ignored my points. I just want to point out that the 2009 Golstone report which accused Israel of war crimes was largely regretted by it's author once he had access to more information. And that was a UN fact finding mission conducted months after the conflict, not some people reading articles posted hours and days after events.

Now, the question is, what is Israel's endgoal?

Honestly? De-facto occupation.

While they don't want to officially re-occupy the strip, the only way they can get out of this situation is to have Hamas either accept a ceasefire with no further concessions from Israel (eg, no lifting of the blockade, unacceptable to Israel and the final sticking point for Hamas) or to cripple Hamas so badly that they have a couple of years of security.

The latter would take months of military presence at least. Decapitating Hamas is unlikely to work; the leadership is too slippery and has too many levels to be effectively disabled that way. Rather the targets would be their infrastructure; their tunnels, weapon supplies and other resources. A comprehensive enough effort could set them back to a near 2007 state, before they managed to solidify their hold over the entire strip's infrastructure.

Honestly, the ground invasion was inevitable but a bad option. This looks at the situation in Israel that lead to the operation. The pressure from within the Israeli government was to go even further, and at the same time;

But the more likely explanation is that Israel just didn’t have any other options. Israel could have continued its aerial and artillery exchanges with Hamas, but this campaign did not appear to be damaging either the will or the capability of Hamas. It could have loosened its rules of engagement and struck Hamas more effectively—but doing so would have inflicted unconscionably disproportionate civilian damage. It could have capitulated to Hamas’s ultimatums to release hundreds of security prisoners and reopened Gaza to shipments of arms- and tunnel-making materials. Apart from the moral implications of such a concession, doing so would simply have strengthened Hamas and ensured additional fighting. An extended cease-fire would be ideal. But so far, Egyptian attempts to broker such a cease-fire seem to have fallen on deaf ears. So Netanyahu was left with a choice that wasn’t really much of a choice.

The problem is how long the offensive can be maintained before they have to withdraw and declare victory. The longer they stay the more damage they can do to Hamas, but the more Israeli soldiers will die. It's very unlikely to me that there will be anything other than a unilateral end to the fighting - eg, Israel withdrawing - even if Hamas efforts end up tapering off due to lack of resources. Hamas gains political capital by killing Israelis and keeping the conflict going, even as they trade it for material losses and lives of Gazans.