Monday, March 31, 2025

Questions APR 1

Conclude Midterm report presentations, begin Final report presentations... Martha, Aidan


1. The greatest advances in health and longevity should go to what?

2. Why was BiDil removed from the market?

3. What broad consensus now obtains regarding health differences between and within groups?

4. Funding in 2014 was 50% greater for research areas including the word gene (etc.) than for those including the word _____.

5. Name an "unthinkable" medical experiment to which incarcerated individuals have been subjected.

6. Creating ethical standards for medical research is the flip-side of what "coin"?

7. Most viewers of The Constant Gardener would probably conclude what, mistakenly, about its fictional drug company?

8. Apart from being extraordinarily lucrative for the local doctors who procure test subjects in developing countries, what's another important reason why so much human research is conducted in Africa and other poor regions outside the U.S.?

9. Research in Nigeria for Pfizer was compromised by an apparently fraudulent claim involving a nonexistent what?

10. What two questions should be prerequisite to conducting research in the third world? What should precede human research anywhere in the world?

CB 7-8
  1. With what deep moral and spiritual questions will we have to wrestle in the coming decades, and  what's the continuum conundrum? 336-7 What categories of genetic modification might we want to add to treatment and enhancement? 339
  2. What does the complexity of sickle-cell anemia remind us of, when we're contemplating "messing with Mother Nature"? 343
  3. How is the moral status of deafness different from skin color and sexual orientation? 348
  4. What DARPA enhancement project is already underway with Doudna's lab? 351
  5. What does Isaacson say about Nozick's Experience Machine thought experiment? 353=4
  6. What was John Rawls's position on genetic engineering? What was Nozick's response? 358
  7. What was Michael Sandel's argument against "playing God"? 365
  8. Doudna became more sympathetic to what view about gene-editing? 369
  9. Should Steve Jobs have thought differently? 371
  10. What's Feng Zhang's objection to making enhancements? 376
  11. What became of Isaacson's edited gene? 383
  12. How did James Watson cross a line? What's the Jefferson conundrum? 386, 390

DQ

  • Do you have a duty to be your best self? To whom?
  • Is aging a "scourge worse that smallpox"? 265
  • How can emergent biomedicine be suitably tailored to public (not just personal & profitable) health?
  • COMMENT: "Health is determined by far more than health care." 269
  • What forms of preventive medicine/health care do you think would have the greatest constructive impact on health in the U.S.?
  • Is there any rationale for ever using human "guinea pigs" for research?
  • Are adequate safeguards in place to prevent future research abuses targeting prison populations?
  • What do you think of South Carolina's kidney proposal 278
  • What's wrong with offering incentives to imprisoned women to donate their eggs?
  • Have you read and/or seen The Constant Gardener? What's your review? (If you haven't, are you mad at Marcia Angell for her spoilers)?
  • What do you think of CG's Hollywood ending (in the film)?

I Vaccinated My Children. But Here’s Why My Neighbors Don’t.

"…a lot has changed. Many Americans have lost trust in public health agencies and the advice they offer, especially in more conservative parts of the country like mine. That declining trust is showing up in personal choices: In 2018, some 46,000 Texans requested vaccine exemption forms from the Texas Department of State Health Services. In 2024, more than 93,000 did.

If I had to do it all over again, I'd still follow my pediatrician's advice and vaccinate my children. But in the years since Covid, I increasingly understand the thought process of my neighbors who do not..."


https://www.nytimes.com/2025/03/31/opinion/measles-public-health-trust.html?smid=nytcore-ios-share&referringSource=articleShare

Phil.Oliver@mtsu.edu
👣Solvitur ambulando
💭Sapere aude

 Trump Administration Abruptly Cuts Billions From State Health Services

States have been told that they can no longer use grants that were funding infectious disease management and addiction services.

By Apoorva MandavilliMargot Sanger-Katz and Jan Hoffman

March 26, 2025

The Department of Health and Human Services has abruptly canceled more than $12 billion in federal grants to states that were being used for tracking infectious diseases, mental health services, addiction treatment and other urgent health issues.

The cuts are likely to further hamstring state health departments, which are already underfunded and struggling with competing demands from chronic diseases, resurgent infections like syphilis and emerging threats like bird flu.

State health departments began receiving notices on Monday evening that the funds, which were allocated during the Covid-19 pandemic, were being terminated, effective immediately.

“No additional activities can be conducted, and no additional costs may be incurred, as it relates to these funds,” the notices said.

For some, the effect was immediate.

In Lubbock, Texas, public health officials have received orders to stop work supported by three grants that helped fund the response to the widening measles outbreak there, according to Katherine Wells, the city’s director of public health.

On Tuesday, some state health departments were preparing to lay off dozens of epidemiologists and data scientists. Others, including Texas, Maine and Rhode Island, were still scrambling to understand the impact of the cuts before taking any action.

Continues Here:  https://www.nytimes.com/2025/03/26/health/trump-state-health-grants-cuts.html

Top F.D.A. Vaccine Official Resigns, Citing Kennedy’s ‘Misinformation and Lies’

Dr. Peter Marks, a veteran of the agency, wrote that undermining confidence in vaccines is irresponsible and a danger to public health.

By Christina JewettSheryl Gay Stolberg and Noah Weiland  The New York Times

·       March 28, 2025

The Food and Drug Administration’s top vaccine official, Dr. Peter Marks, resigned under pressure Friday and said that Health Secretary Robert F. Kennedy Jr.’s aggressive stance on vaccines was irresponsible and posed a danger to the public.

“It has become clear that truth and transparency are not desired by the secretary, but rather he wishes subservient confirmation of his misinformation and lies,” Dr. Marks wrote to Sara Brenner, the agency’s acting commissioner. He reiterated the sentiments in an interview, saying: “This man doesn’t care about the truth. He cares about what is making him followers.”

Dr. Marks resigned after he was summoned to the Department of Health and Human Services Friday afternoon and told that he could either quit or be fired, according to a person familiar with the matter.

Dr. Marks led the agency’s Center for Biologics Evaluation and Research, which authorized and monitored the safety of vaccines and a wide array of other treatments, including cell and gene therapies. He was viewed as a steady hand by many during the Covid pandemic but had come under criticism for being overly generous to companies that sought approvals for therapies with mixed evidence of a benefit.

Continues Here:  https://www.nytimes.com/2025/03/28/health/fda-vaccines-rfk-jr-peter-marks.html

Sunday, March 30, 2025

The public health scenario that keeps epidemiologists up at night

"…What keeps epidemiologists up at night is a scenario where bird flu gains the ability to spread efficiently among humans. Letting the virus spread widely among animals increases its chances of evolving to do so. And if we do end up in this nightmare scenario, the virus will already have mutated — so there's no way to know if such a variant would be milder, or much more deadly. It's also worth remembering that a virus doesn't need a mortality rate of 50 percent to devastate society. Some scholars estimate that the mortality rate of the 1918 flu pandemic was most likely only around 2 or 3 percent..."

https://www.nytimes.com/2025/03/25/opinion/bird-flu-america-death.html?smid=nytcore-ios-share&referringSource=articleShare

We’re In a New Age of Techno-Spiritualism

"…a growing market of A.I. products promise[s] users an experience that closely approximates the impossible: communicating and even "reuniting" with the deceased. Some of the representations — like those offered by HereAfter AI and StoryFile, which also frames its services as being of historical value — can be programmed with the person's memories and voice to produce realistic holograms or chatbots with which family members or others can converse.

The desire to bridge life and death is innately human. For millenniums, religion and mysticism have offered pathways for this — blurring the lines of logic in favor of the belief in eternal life..."


https://www.nytimes.com/2025/03/30/opinion/grief-tech-ai-optimized.html?smid=nytcore-ios-share&referringSource=articleShare

The Story of One Woman Who Fell Prey to the Medical Freedom Movement

"…Ms. Kali had grown up in a family that revered the principles of all-natural living. She liked her burritos G.M.O.-free and her milk raw. She was wary of medical interventions that exposed the body to chemicals and radiation. Sometimes she suspected that the entire medical system had been captured by special interests. She wanted health care that felt caring, not the impersonality and inaccessibility that she encountered in hospitals. And so while she agreed to undergo surgery to excise her tumor, she declined to follow up with an oncologist. Instead, she began searching for alternatives.

While only a small percentage of people diagnosed with cancer reject standard medical care entirely, surveys have found that one in five Americans has used alternative medicine in place of conventional medicine at some point. Nearly one in three Americans has reported avoiding doctors, often owing to distrust of the medical system or a history of negative experiences.

In her quest for options outside traditional medicine, Ms. Kali found herself part of what has become known as the health freedom movement. In the past 25 years, the movement has stitched together yoga moms, flag-waving anti-maskers, alternative healers, disenchanted doctors and other fellow travelers who believe that the government has no business meddling in personal health decisions. With the installment of Robert F. Kennedy Jr. as health secretary, what was once a fringe coalition of grass-roots activists and libertarians now controls the regulatory halls of power..."


https://www.nytimes.com/2025/03/29/opinion/medical-freedom-cancer-rfk.html?smid=nytcore-ios-share&referringSource=articleShare

Phil.Oliver@mtsu.edu
👣Solvitur ambulando
💭Sapere aude

Should There Be Limits to Research on Human Embryos?

"…what kind of testing can be done on embryos in the name of optimizing future lives. Embryos are at the center of divorce cases that are part property dispute, part custody battle.


What kind of rules should govern this research? Should businesses that profit from embryos be subject to any kind of oversight? And how should the law speak of them? Wherever embryos appear, they bring with them serious ethical and intellectual questions about what meaning or place they hold in our society.


The political fights over abortion demand a great deal of attention. But embryos also demand and warrant a meaningful conversation about everything they represent: values, knowledge, family, religion, health, life, death and more. The boundaries of what we are doing with embryos are shifting quickly. Any attempt to shape the future of how we treat them has to engage with these questions now…"

https://www.nytimes.com/interactive/2025/03/25/opinion/human-embryo-experiments-timeline.html?smid=nytcore-ios-share&referringSource=articleShare

Phil.Oliver@mtsu.edu
👣Solvitur ambulando
💭Sapere aude

Thursday, March 27, 2025

All hands on deck

I'm back, to class if not fully to form. We're behind, obviously, and need to catch up. All who had their presentations postponed, be ready. 

And: Happy Opening Day! Expectations for my team are low, but today they begin the year in first place. Let's go!

 

And remember:





Tuesday, March 25, 2025

Questions MAR 27

Presentation: Michael, Sawyer, Madi, Martha

1. In this touted Age of Genomics, what frequently follows the hopeful hype about gene therapy?

2. Steve Jones says we know what of genetics?

3. What was Francis Collins' prediction in 2000? In 2014?

4. What's the best way to engineer a tall person, and what does that tell us about the effects of "Many Assorted Genes..."?

5. "Anonymous" tissue samples can be what?

6. What is Jessica Cussins' practical objection to the results of DTC genetic tests?

7. What more than doubled in illustration of the "Angelina Jolie effect"?

8. There aren't enough what to support population-wide screening for the BRCA genes?

9. The UC-Berkeley DNA project was intended to introduce students to what?

10. How should leading geneticists have responded to loose talk in the early '90s (and still) about "the gay gene," "the violence gene," etc.?


DQ
  • Who's responsible for over-hyping the promise of gene therapy?
  • Why is the history of genomics so full of unfulfilled promise?
  • If short people are discriminated against, is the solution to engineer tall people? Or to oppose discrimination more aggressively?
  • Do you agree that we should divert billions from genomic research to behavioral modification? 249
  • Why do patients who support genomic research nonetheless "want to be informed..."? 251
  • Is there any reason in principle why 23andMe's algorithm could not be corrected to detect and distinguish gene mutations that are and are not life-threatening? 253
  • Is there anything ethically wrong with women electing for prophylactic mastectomies?
  • Do the risks of universal screening for the BRCA genes outweigh the benefits? 
  • If there were enough genetic counselors to support population-wide screening, would you support it?
  • Should patients be informed of mutations that are not found to correlate with increased cancer risk? 257
  • Is it in fact "common knowledge" that there isn't a gene for homosexuality, etc.?

CB
  1. (Oops - published out of sequence. See previous for CB part 6)

Health news... Weekly health quiz... WHQ 3/8... WHQ 3/3...  Treating Alzheimer's... Her son died. And then anti-vaxers attacked her

No class MAR 25

I'm sorry to report I'm still sick (but improving). Do continue to stay on track with the assigned readings and your posts. And sign up for Final Report Presentations (which will now probably begin late).

Just in case we need it to get caught up, save the date (from our designated final exam schedule): Thursday May 8, 3:30 - 5:30 pm

Monday, March 24, 2025

Why I Got the Measles Vaccine at Age 63

"…My own safety wasn't my chief concern. Doing everything I can to protect my fellow human beings who cannot be vaccinated — babies too young for the vaccine, people with compromised immune systems, people who are allergic to the components of the vaccine — seems to me to be the only moral thing to do for anyone living in close community with other people. And that's almost all of us.

Community is a concept that the MAGA movement is working overtime to undo, but human beings are a social species. We depend on one another for safety and survival. When we vaccinate our children, we are keeping them safe, but we are also keeping those who cannot be vaccinated safe. It's part of the social contract..."


Margaret Renkl https://www.nytimes.com/2025/03/24/opinion/measles-vaccine-babies.html?smid=nytcore-ios-share&referringSource=articleShare

Sunday, March 23, 2025

Appreciating our infinitesimal interval of life (and not "crowding the room," Transhumanists)

Ray Kurzweil, meet Epictetus and Carl Sagan...

"The astronomer Carl Sagan, one of my scientific role models when I was a kid, invited us to reflect on the fact that we literally are stardust: the chemical elements of which we are made originated after the explosion of a supernova somewhere in the neighborhood of the solar system, and billions of years of evolution later such matter became the very molecules that constitute our bodies. It is a wonderful, awe-inspiring thought.

But the converse of that is what Epictetus is getting at: we will, again literally, return to dust, recycling our chemicals, allowing new living beings to take our place in the workings of the universe. It doesn’t matter whether those workings have a point or whether they are just what they are: either way, we came from cosmic dust and we will return to cosmic dust. If anything, this should make us even more appreciative of the infinitesimal interval, from a cosmic perspective, during which we are alive and we eat, drink, and love. Regret at the anticipation that this interval will end is not just irrational but entirely unhelpful.

And yet, some people are not persuaded of this at all. On the contrary, a number of techno-optimists think that death is a disease that should be cured, and they are investing good money in the effort. Broadly speaking, they call themselves “Transhumanists,” and quite a few of them can be found among the white male millionaires in Silicon Valley, where many of the world’s most influential tech companies are located.

Perhaps the most famous and influential of the bunch is Ray Kurzweil, a futurist (someone who thinks he can study and predict the future) currently working at Google to develop a software capable of understanding natural language. Kurzweil has a number of important achievements under his belt, including the development of the first omni-font optical character recognition system. Age sixty-eight at the time of this writing, he has been arguing for some time that the way to immortality will be to upload our consciousness into a computer, which he claims will be possible any day now. Indeed, we better manage that feat before the so-called Singularity, a term invented by the mathematician Stanisław Ulam to describe the moment when computers will outsmart people and begin to drive technological progress independently—and perhaps even in spite—of humanity itself.

This is not the place to explain why I think the whole idea of a Singularity is predicated on a fundamental misunderstanding of the nature of intelligence, or why “uploading” our consciousness to a computer is extremely unlikely to ever be possible, since consciousness is neither a thing nor a piece of software. Here I’m more interested in the chutzpah displayed by people like Kurzweil as well as by his almost cultlike following, who think of themselves as so important that they ought to, godlike, transcend the laws of nature itself, never mind the fact that they are spending inordinate amounts of money and energy that could be directed toward ameliorating actual, urgent problems the world faces right now, or the disastrous ethical and environmental consequences of their success (if it were possible).

Who, exactly, would have access to the new technology, and at what price? If we succeed in becoming physically immortal—the alternative to uploading hoped for by some Transhumanists—will we keep having children? If so, how would an already diseased planet sustain the thirst for natural resources of a population that grows so relentlessly and manage its ever-escalating production of waste products? Ah, but we will expand beyond Earth! We shall colonize other worlds! Never mind that we still don’t know of any other habitable worlds in the galaxy, or that we have no clue about how to get to them, if they’re out there.

The more I think about Transhumanism the more the word hubris, famously invented by the Greeks precisely for such thinking, seems awfully appropriate. The likes of Kurzweil simply don’t want to leave the party, it seems to me, no matter what the cost, and regardless of how privileged they have been while attending it. Which is why I imagine him having this conversation with Epictetus: “No, I wanted to go on feasting.” “Yes, those at the Mysteries too want to go on with the ceremony, and those at Olympia to see fresh competitors, but the festival is at an end. Leave it and depart, in a thankful and modest spirit; make room for others. Others must come into being, even as you did, and being born must have room and dwellings and necessaries. But if the first comers do not retire, what is left for them? Why will nothing satisfy or content you? Why do you crowd the world’s room?”"

"How to Be a Stoic: Using Ancient Philosophy to Live a Modern Life" by Massimo Pigliucci: https://a.co/bIKCHBh

Saturday, March 22, 2025

Shocking oddball (& longevity guru)

How Bryan Johnson, Who Wants to Live Forever, Sought Control via Confidentiality Agreements


In a Netflix documentary released in January, Bryan Johnson, a tech entrepreneur turned longevity guru, walked people through his morning routine. After tracking his sleep, he would wake up early to conduct audio therapy and hair therapy, do an hour of exercise and take 54 different pills with a drink called "the green giant," he said.

Mr. Johnson also talked about his long-life start-up, Blueprint, which sells health supplements, blood-testing equipment and other products tied to his personal diet and recommendations.

"By doing Blueprint, one of the key objectives is to achieve the lowest possible biological age," he declared. He added that his health regimen had "reversed my biological age 5.1 years."

The Netflix feature was a breakout moment in Mr. Johnson's five-year campaign to become the face of one of Silicon Valley's most oddball fascinations: the pursuit of everlasting youth. The 47-year-old former Mormon missionary has become known for experimenting on his own body to defy aging, captivating the media and his nearly four million social media followers by receiving the blood plasma of his then-17-year-old son and repeatedly shocking his penis to increase his erections...


https://www.nytimes.com/2025/03/21/technology/bryan-johnson-blueprint-confidentiality-agreements.html?smid=nytcore-ios-share&referringSource=articleShare

Friday, March 21, 2025

Questions MAR 25

Time to sign up for final report presentations, and sign on as authors.


Presentations: Sawyer, Madi, Martha


1. What is the American Society for Reproductive Medicine's position on elective non-medical egg freezing?

2. The U.S. is the only developed country in the world without what?

3. Henrietta  Lacks's cells became the first what?

4. Henrietta's chart described her "household" as what?

5. Elsie Lacks was described as "touched," meaning what?

6. Why wasn't carcinoma in situ treated by most doctors in 1951?

7. Who was George Gey?

8. Why wasn't Gey's assistant excited about the new cell sample?

9. The HeLa cells weren't merely surviving, they were _____.

10. What were Henrietta's children's consuming questions?

---
CB
  1. CRISPR was used to edit which kind of Victoria Gray's cells? 246
  2. The P53 gene does what? In what species is it more common than in humans? 251
  3. What is ODIN? 255
  4. What are anti-CRISPRS? 260
  5. What do biotech utopians consider immoral, and how do technoskeptics and bioconservatives respond? 268
  6. What did Roger Ebert say when he saw Gattaca? 276
  7. What did the Kass Commission's report warn about? 281
  8. What led Doudna to become more engaged in policy discussions about how CRISPR should be used? 286
  9. What kinds of humans did Vladimir Putin say he could imagine creating with CRISPR? 294
  10. What preempted high-minded ethical discussions about germline gene editing in Novembr 2018? 313
  11. What did David Baltimore, David Liu. and Doudna think of Jiankui's embryo editing? 321-3
  12. What did Josiah Zayner say that reminded Isaacson of Steve Jobs?  325


DQ

  • What family-friendly workplace policies would you advocate?
  • Is the egg freezing benefit at Apple and Facebook a progressive or retrograde policy, with respect to gender equality?
  • Is Henrietta Lacks still "all but forgotten"?
  • Is consent to "any operative procedures... deem[ed] necessary" too broad? 234



Health news... health news quiz

Supplements Won’t Prevent Dementia. But These Steps Might.

Scientists still have no magic shield against Alzheimer’s disease and other dementias. Yet there is evidence that some strategies may help

....the most helpful approach Donna Kaye Hill uses to protect herself from dementia probably isn’t taking fish oil.

It includes using medication to control her blood pressure. And reading biographies and mysteries and joining a book group with friends. And taking a four- or five-mile walk, five days a week, with a yellow Labrador named Annie.
==
Family Medicine, Blood Relations
At the end of his life, my father went from doctor to patient, from scientist to subject.By James Marcus

We like the heart to behave—no skipped beats, no atrial flutter, just the regular, precious, plodding cadence. For this we will sacrifice much. The medicine my father began taking for his irregular heartbeat, in 2014, could have turned his skin gray, or caused him to grow breasts, or collected in tiny granular deposits behind his eyes, so that everything he looked at would have had a blue halo. None of this happened to him. Instead, he was cold all the time...

a staffer at the hospital introduced my mother to words we didn’t want to hear: “palliative care.”

It shouldn’t be so. The word comes from the Latin pallium, which is a cloak. It means that the patient will be enveloped, protected, wrapped in a mantle of painkilling techniques that are often pharmaceutical but may also consist of old-fashioned human tenderness. It’s what we should want for the people we love. But it also signals that the fight is over. It is a white flag, a coming to terms with extinction.

My mother was given a choice between moving my father to a nursing home and moving him to a hospice facility. She wasn’t sure. The decision was further complicated in late April, when he sat up in bed for a moment and told her, “I don’t know if I can beat this, but I want to live.” How could she now consign him to a hospice, which was a terminus—the end of it all? She was terrified that he might regain consciousness there, ask the nurse where he was, and abandon all hope when he heard the answer. She couldn’t stand the thought...

The New Yorker (@NewYorker)
Measles is highly contagious and potentially deadly—and entirely preventable through vaccination. So why would people choose to ignore the solid, evidence-based recommendations of the government and the health-care system? nyer.cm/NQ3Xj5h


Why Measles Is a Quintessential Political Issue of Our Time
By Masha Gessen

...Measles is a quintessential political issue of the late two-thousand-teens, one that turns on the conflict between facts and lies. There has even been some reporting that Russian trolls have been spreading anti-vax propaganda. If they are, they are tapping into existing tensions and preconceptions, just like they do when they spread electoral propaganda. On Facebook, a tiny cluster of anti-vax pages seems to have disproportionate reach. And, just as with other kinds of propaganda, the key question is what makes the soil fertile for it.

Why would people who care about their children’s health choose to ignore the solid, evidence-based recommendations of the government and the health-care system? The simple answer is because they don’t trust the government or the health-care system. Theirs is not an unreasonable position. The American health-care system is opaque and profit-driven. Working in concert with the pharmaceutical industry, it gave us the deadly opioid epidemic. It gives us the highest infant-mortality and the lowest life-expectancy rates among the world’s developed countries—as well as the highest bills...
==
Samantha Bee Update-

Slugging the Sacklers
A lawsuit against Purdue Pharma has thrown back the curtain on the Sacklers, one of America’s wealthiest families. Their company produced OxyContin and subsequently covered up the drug’s addictive qualities, according to the suit. Until recently, the Sacklers have been known for their philanthropy more than their business. But that is changing, as Samantha Bee pointed out in a withering segment of “Full Frontal” on Wednesday...

SB on the Fox News White House
==
Directions to the Undiscovered Country
Advice for the Dying (and Those Who Love Them): A Practical Perspective on Death, by Sallie Tisdale, Allen & Unwin, 256 pp, £12.99, ISBN: 978-1760632700
“Let us beware of saying that death is the opposite of life,” cautioned a certain nineteenth century German philologist with a nose for mischief. “The living is only a species of the dead, and a very rare species.” As if to echo Nietzsche’s oft-quoted formula, the lead title of Tisdale’s book in its original US impression was Advice for Future Corpses. The apparent sanitisation of the title for the British market is rather an irony, given that it is part of the author’s purpose to confront a topic she insists is too often hidden, evaded or euphemised. The opening page states:
In Victorian times, children were kept away from anything regarding sex or birth, but they sat at deathbeds, witnessed deaths, and helped with the care of the body. Now children may watch the birth of a sibling and never see a dead body … many people reach the end of their own lives having never seen a dying person.
The problem of offering a practical perspective on death is summarised at the outset. “Birth and death are the only human acts we cannot practise,” writes Tisdale, and so “death looms ahead as a kind of theory.” There are no dress rehearsals for death. Dreamless sleeps will be woken from; the deaths of others do not necessarily carry instruction as to how one ought to go into that good night, gentle or raging. Practical advice then must deal with the concrete details of death; Tisdale’s book addresses both future corpses and their carers and families, and indirectly, health professionals and advocates of varying stripe. The advice is direct. The grammatical mood is usually imperative, the mood and tone of the author running the spectrum from compassionate to faintly peremptory. The book is “about preparing for your own death and for the deaths of people close to you”. A bank of experience built up as a palliative nurse makes Tisdale a singularly qualified counsellor of corpses-to-be, and allows her to lay out the various dull, uninspiring, sometimes absurd practicalities attending the business of dying while avowing simultaneously “the strange, undeniable fact that the presence of death can be joyful”...
 the book proper closes with a three-page paean to life, a fragile and ever-endangered thing, which only because it is hedged about by death offers delight and beauty. The chapter celebrates joy; and as Tisdale insists, joy could attend the immediate presence of death, so death’s general, pervasive presence in our lives confers meaning on them. Mortality and vulnerability are the larger context required to make one’s experiences special. These are not original sentiments, but Tisdale has in a sense earned this closing through the hard, clear-eyed look at death and dying that precedes it. Were one averse to this late turn to the lyrical, there remains that hardness and clarity to remind one that the living is after all but the rarer type of the dead, and that to be grateful for life must entail some gratitude to the dead – not only one’s direct ancestors, but to the countless, mostly nameless host gone before one to fatten the maggots.
The Lancet recently established a Commission on the Value of Death (which includes Irish authors Mark O’Connell and Seamus O’Mahony), a marvellous way of framing the issue that reminds us that people must die so that others may live, and that to strive after, never mind achieve, immortality (the dream of certain Silicon Valley denizens, as O’Connell records in To Be a Machine) would be a scandalous violation of the intergenerational contract with future humans. One might recall Elias Canetti’s analysis of the figure of the survivor in his eccentric opus Crowds and Power, his assertion that we draw sustenance from the deaths of others and his proposition that survival where others have succumbed is productive of the feeling of power. One might find the ground for a sober reckoning with death in the thought that one’s own flourishing is purchased at the cost of others’ perishing, and thereby discover some renewed solidarity with both the living and the dead; and finally meditate upon a cast-off thought from Canetti’s journals which stands, solitary and gemlike, among the jottings: “Perhaps every breath you take is someone else’s last.” Paul O'Mahoney
==

Thursday, March 20, 2025

CLASS CANCELED Thursday 20th

 Stay on track with reading and posting, and scheduled presenters plan to report on Tuesday.

The Entire Future of American Public Health Is at Risk

Posted from Vandy walk-in clinic, awaiting test results… [UPDATE: it's not strep or covid, says the doc, just likely one of the myriad respiratory viruses in current public circulation. Probably picked it up on my recent trip, in Washington or the airport.]

"…In the aftermath of the pandemic, we've talked a lot about the loss of public trust in science, but the collapse of trust in government, especially among the young, might be even more worrisome. (The pandemic really did a number on us.) One result is that many more Americans now seem to believe they should be in charge not just of choices about their own health but also of the entire health information ecosystem that informs those choices, as well. Many regard well-being as something you can mold on your own at the gym or perhaps buy at the supermarket, in the supplement aisle — so long as you did your own research (at least listened to a good podcast) and brought your own list.

What is on that list isn't necessarily important, as long as it runs against the establishment grain. Mehmet Oz is about to be confirmed as the head of the Centers for Medicare and Medicaid Services, for instance, though only 21 percent of the health recommendations he offered on his television program were judged by a group of researchers to have even "believable" evidence to support them. Kennedy stated that "there is no vaccine that is safe and effective" (he later claimed that the quote was "misused") and has responded to the Texas measles outbreak not by urging everyone to get vaccinated but by shipping vitamin A. He has also praised steroids and cod liver oil — neither of which are part of routine treatment protocols, and neither of which have produced persuasive research suggesting they should be integrated into those protocols.

The MAHA movement rallies itself under the banner of reform, and it does raise undeniably important questions about why the richest country in the world is so much less healthy than its peers. But what it really heralds is a new age of public-health libertarianism, which is to say, a pretty explicit war on all the things that make health a "public" good, sustained by mutual aid, in the first place. At least, it marks the direction of change: away from solidaristic responsibilities and toward something both more suspicious and more solipsistic, by which individuals draw down biomedical capital accrued over many decades without feeling any real need to replenish the well..."


David Wallace-Wells
https://www.nytimes.com/2025/03/19/opinion/public-health-trump.html?smid=nytcore-ios-share&referringSource=articleShare