Sunday, February 25, 2007

Scorsese finally joins the Oscar club - International Herald Tribune

I can't believe I'm actually excited for him but strangely enough I always thought he was perpetually getting snubbed by the Academy for some strange reason.

But in a matter of speaking, this is a strange tribute not just to him but the the Hong Kong movie industry as well. My understanding is that for a very long time, the HK directors were deriving much of their influence from him. And in The Departed, he returned the favor by drawing on Infernal Affairs.

And finally a win for Mr. Scorsese. Sweet.

Tuesday, February 20, 2007

Stereotypes and Statistics in the Administration of the Criminal Justice System

An interesting case that I came across while doing readings for Equal Protection. The case of United States v. Armstrong was decided before the US Supreme Court in 1996 and it returned to the the above issue post McCleskey v. Kemp (1987).

Facts: Armstrong, the defendant was an African American who had been charged with "conspiring to possess with intent to distribute 'crack' cocaine". Sought discovery from the prosecution to gather evidence supporting his claim that the government was not prosecuting similarly situated suspects of other races.

Trial history: Court of Appeal upheld order granting request

Holding: 8-1 reversal on basis that the defendant had failed to make threshold showing of similarly situated individuals of a different race were not prosecuted

Reasoning: Threshold showing is “a credible showing of different treatment of similarly situated persons” on the basis that it struck the best compromise between government’s interest in prosecution and defendant’s interest in avoiding selective prosecution

The Supreme Court derided CA for reaching its decision in part on the basis that it started “with the presumption that people of all races commit all types of crime – not with the premise that any type of crime is the exclusive province of any particular racial or ethnic groups” without any backing and appears contradicted by the (then) most recent statistics of the US Sentencing Commission

“Presumptions at war with presumably reliable statistics have no proper place in the analysis of the issue” and here are the interesting stats they cited, >90% of person sentenced in 1994 for crack cocaine trafficking were black; 93.4% 6f convicted LSD dealers were white; and 91% of those convicted for pornography or prostitution were white

I think there is an element of begging the question and putting the cart before horse but I think they is also some truth to the argument that sometimes the discrepancy is not due to some form of invidious discrimination but reflects the reality of the situation.

Peace

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Monday, February 19, 2007

Home on the Strange: J-Horror Will Eat Itself, Part 1



I don't normally do this but I need to get this off my chest.

I absolutely hate J-Horror like The Ring, the Grudge, Still Water and all the other such movies. My instinctual reaction is "you're dead, you died a tragic death, boo hoo. So why the hell are you going around killing people just because they happen to be staying in the place you were killed".

I'm a BtVS (Buffy the Vampire Slayer) Fan, I've read (it was much faster than watching it) all the episode transcripts from Season One to Angel Season 5.

Repeatedly.

SO YOU DO NOT CAST SARAH MICHELLE GELLER RUNNING AWAY FROM A SNOT NOSE TEN YEAR OLD GHOST BOY WITH BIG EYES.

Thank you.

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Sunday, February 18, 2007

Carnival Of The Godless #60 | Unscrewing The Inscrutable

More godlessness goodies. It's one of the carnivals I read (the other being the Skeptic's Circle and Carnival of History) and I don't think it's being publicized enough back home in Singapore. So here's my little contribution.

And yes, I'm out, I'm an Atheist.

Peace.

Reconciling faith and academia - The Daily of the University of Washington Online

Reconciling faith and academia

February 16, 2007
By Celeste Flint

With midterms phasing out and scores pouring in, I’m sure most of us have at least considered challenging our grades. Amid these debates of what should pass and what deserves to fail, it leads one to question on what principles students should be graded. More specifically, should a student’s acceptance of the ideas taught in class have anything to do with their grades?


I was somewhat surprised at the attention The New York Times gave University of Rhode Island Ph.D. graduate Marcus Ross for writing a dissertation that, although it followed all the scientific principles taught at his university, he personally disagreed with. Ross’ ultimate goal in receiving the Ph.D. was to be a good paleontologist. However, because of religious beliefs, he just happens to disagree with Darwin’s theory of evolution.

Ross’ dissertation was accepted, but it’s frightening to think that professors from other universities openly and avidly disagreed with the decision because of Ross’ religious views. This discrimination doesn’t just affect those with religious beliefs, but anyone with moral, social and political values that differ from those of the educated elite.

I once took a sociology course at a community college, where I was among the more studious classmates. However, after looking over an essay exam, I noticed I lost a few points on a question with the only comment being that although I understood all the concepts well, I didn’t sound like I believed them. The truth is I didn’t accept half of the material. At first I laughed about it, as I was entertained by the teacher’s frustration, but still, I was discriminated against for holding different beliefs about society than the teacher did. The most frustrating part was that I understood the ideas better than the majority in the class who accepted them.

Although most professors respect differing opinions, especially if they are well-supported, I’ve seen and experienced several occasions when agreeing with the teacher was the ticket to a good grade. For Ross, his dilemma was equivalent to a socialist in an American economics course being told he couldn’t pass because he doesn’t uphold the values of capitalism. To master the knowledge of something doesn’t necessarily require one to believe it or to even think it right.

This fuzzy line is best defined by the misconception that a professor’s job is not just to teach ideas but to also indoctrinate students with them. The beauty of education and science is that it invites us to challenge our beliefs and the beliefs of others but being able to question popular and even scientific beliefs is contingent on knowing that they could actually be wrong. When professors indoctrinate students instead of teaching them, it closes the door to inquiry and exploration of ideas.

All things should be taken in moderation; the authority of a well-educated person shouldn’t be placed on par with an upset student. However, it is both arrogant and asinine to assume that because someone rejects popular and even scientific ideas, that they neither understand the ramifications of their beliefs, nor have valid and logical reasons for believing what they choose.

Michael Dini, an opponent to religious individuals like Ross in the scientific community, was quoted in The New York Times as saying, “Scientists do not base their acceptance or rejection of theories on religion, and someone who does should not be able to become a scientist.”

Although the argument that religious people take what they believe solely on faith can be true, people have been defending their beliefs with quality reason and rhetoric since the days of Plato and Aristotle. Don’t assume that because individuals value faith they can’t logically and even scientifically defend their beliefs. It wasn’t right when Galileo was made to recant his scientific ideas, so why should students be expected to recant their beliefs for the adoption of popular ideas?

Cheap blog post because this actually raised enough of an eyebrow and a mutter or two than I was once again "motivated" to reply...

Here's the full text of my comment on the site, any additional amendments are in italics.

It would appear that Ms. Flint has very erroneously conflated a number of issues that have absolutely no bearing with one another and does not necessarily support her argument.

Amongst which is the very first example she cites, the Dr. Ross incident. Here’s a fuller picture of what actually happened with regard to Dr. Ross and why his situation is so downright odd if not egregious.

He successfully defends his dissertation on geosciences (he's a paleontologist for goodness sake!) but is a YEC (young earth creationist) i.e. someone who believes that the world on which we reside on is between 6000-1000 years old based on a very literal reading of the Bible (Literal 7 Day creation in Genesis and a backward counting of the years based on who beget whom). His dissertation on the other hand repeatedly accepts and refers to events that happened tens of millions of years ago.

Therefore opposition to his receiving the Ph.D. is not simply because of his opposition to Evolution (which is merely a byproduct of his young earth beliefs) but simply because his own personal beliefs are so fundamentally at odds with his entire dissertation and field. One really wonders how he would respond to the question as to how much confidence he has in his results.

To be honest, it's a bit like David Irving getting a 2nd Ph.D. by demonstrating why the Holocaust is a historical event and in fact much worse than what was previously known.

Further, there is a very real problem of someone using this Ph.D. in a very misleading fashion by posing as an authority on a position that led to one’s Ph.D. in the first place. Some background here, he's affiliated with the Discovery Institute, doyens of Intelligent Design (To paraphrase Dr. William Dembski, John's logos reformulated in the idioms of the mathematics of irreducible complexity). And he will be cited as an authority on why apparently Evolution is bunk, notwithstanding the fact that his entire dissertation rests on and probably reaffirms the various hypothesis of the Theory of Evolution once again.

Lastly, while Ms. Flint highlights a potential problem with disagreeing with the preferred position and theories of the professor, there is still a huge distinction to be made between the social sciences (Economics and Sociology) and the sciences (Geosciences and Evolutionary Biology) insofar as the rigourness of scientific facts and theories are much less in doubt in the latter simply because one does not have to deal with humans and their nature. Therefore, while one might well quibble whether a particular theory is to be preferred in a non-science field (We could have loads of fun debating what the best form of government is), the same cannot be said within Science (Reality is what remains even when you choose to ignore it), especially where there is a stunning lack of evidence for either a young earth or creationism and a tremendous amount of evidence across a good many disciplines supporting the very old age of the earth and the universe and for Evolution.

Lastly, there is a reason it’s called faith and not reason, "quality reasons" or not. Recanting a belief is not the same as recanting reality despites the constant push for us to do so when we are asked to have "faith".

Dr. Ross simply could not defend his belief and got his degree by engaging in verifiable reality. If nothing else, we would keep that in mind.

Peace

Thursday, February 15, 2007

Rogue development aid - International Herald Tribune

Very good article and one that I seriously hope the author (who is Editor in Chief of Foreign Policy i.e. the glossy and prettier sister of Foreign Affair) will expend in an upcoming issue.

There is a a much more self-interested side to developmental aid and that is of Dollar Diplomacy. It needs to be emphasized that many nations partake in it, whether it is as a gifter or as a partaker. The issue is fairly complex and I think I'm generally on balance not in opposition to the concept insofar as it is an instrumentalist functional concept.

The problem is that such instrumental formalist structures are not just tools or procedural. There is a substantive component wherein it codifies and stratifies existing power structures. So for example, the rule of law (or by law) can end up entrenching the status quo which can be massively detrimental or unfair to whichever or whoever is the downtrodden e.g. all contracts are to be enforced and any law that infringes on contracts will be struck down will hurt parties with less bargaining power and as time goes on see a concentration of power in those with existing power because the law will not remedial or even allow for a remedial of such a situation.

Therefore the issue and I think one that comes out fairly clearly in the article is whether the state giving the aid has its self-interest aligned with that of the interest of the developing state and whether those interests are in line with the global interest.

Say what you will about the US as a hegemon, I can scarcely see how China could not be worse and this is a good example why. They don't see it in their self interest to align themselves with the global long term interest. In essence, they are exhibiting the very worst of neo-imperialism and the sort of activity during the Cold War where one supported any state that opposed the other side no matter how antithetical they might be to your side i.e. the enemy of my enemy is my friend....even if he would otherwise be my enemy.

So what we have here is China essentially buying access to natural resources through offering aid without strings. So here's the money, do what you want, we don't care about the corruption or that it will not benefit your citizens, now where's our contract? At least the EU and US appears to care and the fact is, they generally do. Onerous as these strings maybe (and stupid like in the case of the global gag rule), the general rule is that they seek not to enrich the ruling elite but a genuine concern with ensuring the project succeeds, thereby helping the citizens those projects are supposed to help.

Or to put it even more simply, I don't trust China's interests.

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Saturday, February 10, 2007

Law and Genetics Assignment 1 (Access to Health Care Insurance: Genetic Discrimination)

(not a fantastic grade admittedly but it's decent enough, will be putting up more law school exam answers over the next few days)

It is worth setting out, at the outset, the rationale behind Rothstein/Anderlik’s distinction between the legitimacy of using genotype and phenotype as the discriminatory or intelligible criterion.[1] Their first definition of discrimination is one that has an intrinsically negative connotation which they identify as “evaluating people based on ‘questionable stereotypes’ rather than individual merits and abilities, invading people’s privacy, the morally and publicly unacceptable stratification of the community into ‘haves’ and ‘have-nots’, and the punishment of people for characteristics over which they have no control in violation of cherished beliefs in justice and equality.”[2]


The second definition is what they term “actuarial definition” i.e. “an all-purpose descriptor for the practice of making distinctions” and to this they attach the notion that irrationality is the basis of social unacceptability and therefore “only irrational distinctions should be socially unacceptable”.[3] Furthermore, with specific reference to the insurance industry they explain that “discrimination only becomes problematic where there is no sound actuarial basis for the manner in which risks are classified, or individuals with equivalent risks are treated differently”.[4]


Under these definitions, the distinction made is fairly intuitive and particularly so in the cases of asymptomatic individuals who essentially fulfill both types of discrimination. After all, while a phenotype is the existing expression of a particular genotype by a cell or an individual, a genotype by contrast appears to be a potentiality. And according to the authors “[a] large majority of the public considers discrimination against these [asymptomatic] individuals as unfair because current opportunities are being denied to seemingly unaffected individuals merely because a genetic test or assessment indicates an increased risk of future incapacity.”[5]


There are, thus, effectively two manners in which we can conceptualize this distinction. Firstly, that it is definitional/formal distinction as defined above. Alternatively, that it is a functional one i.e. the distinction is made because it fits certain positive and normative criteria. Therefore, under this notion, a rigid adherence to the formal genotype/phenotype distinction is to lose sight of what the distinction sought to do in the first place i.e. to distinguish between what is or is not genetic discrimination.


On the issue of reconciling the genotype/phenotype distinction to the Court, in Katskee v. Blue Cross/Blue Shield of Nebraska,[6] determining that Katshee’s familial susceptibility as a “disease” for the purposes of coming within the insurance contract, it cannot be ignored that this was a review of a summary judgment and therefore the court automatically “views the evidence in a light most favorable to the nonmoving party and gives that party the benefit of all reasonable inferences deducible from the evidence”.[7]


But more importantly, this was a court simply construing and interpreting this insurance contract like they would in any other form of a contract i.e. in accordance with general principles of construction and will be “guided by definitions found in dictionaries and additionally by judicial opinions rendered by other courts which have considered the meaning of these terms”.[8] And therefore, based upon various lay and medical dictionaries, as well as judicial decisions having defining the term (‘disease’) broadly, there was a resulting attribution on the part of the insurer to also adopt that broad interpretation.[9] As such, it would appear hard to square a logical and principled distinction with what is ultimately a pure legal categorization.


Nevertheless, based on the “functional” distinction, the decision is arguably consistent insofar as it would have been unfair under the circumstances to treat Katskee differently simply because her condition was that of a genotype and not phenotype. By focusing merely upon the “predisposition to an illness (cancer)”, as Blue Cross would have done, is to blithely ignores insurable diseases/conditions/illnesses such as hypertension (high blood pressure) or a high cholesterol level which in and of themselves are not harmful per se but have a similar (albeit higher) chance of developing into cardiovascular diseases and higher risks of cardiovascular accidents. This bears directly on “actuarial discrimination” as it is treating equivalent risks differently. Seen in that light, it is unfair that the lack of “symptoms” would deny Katskee “the most medically appropriate treatment available”.[10]


While it cannot be denied that insurers are legitimately allowed to inquire into one’s family history of hypertension and high cholesterol levels and thereby adjust premiums accordingly, but the underlying point is that in those cases, a predisposition is sufficient for the insurer to pay for medication e.g. Lipitor that is in effect a preventive measure.


Nonetheless, there is a very appealing logical symmetry in the argument that if Blue Cross is prohibited from discriminating against Katskee on the basis of genotype, then it should be absolved from paying for services associated with that genotype unless it has actually manifested in pathology. In fact, one could go even further and argue that in this instance, it is not even an insured risk and therefore, they ought not to be liable, manifestation of pathology or not. That basis would be it is an unfair bargain insofar as insurance is a pricing of risks through premiums; that it is a private industry with the basic motive of profit maximizing; and that without the ability to discriminate on the basis of genotype, it is unable to price that risk effectively.


But it is submitted that there are a number of justifications, legal or otherwise, that support the case and the proposition residing within it and on balance justifies supporting it. Firstly, and most fundamentally, it cannot be the intent of the legislature, having outlawed genetic discrimination in health care insurance to somehow allow genetic discrimination in through the backdoor as it were by allowing insurers to reject medical treatments on the basis of said genetic condition. Secondly, the legal reasoning is not flawed if one accepts the basic premise of the broad scope of the terms e.g. disease/illness as judicially defined previous and variously in the dictionaries. This is linked to the fact that the insurers are the ones controlling what is in essence a standard form, with the corollary that what one controls, one can amend. And in this instance they have chosen to adopt a broad definition keeping in mind that they always had the power to amend it and therefore the court is not acting in an arbitrary and capricious fashion by holding them to their own bargain.


Alternatively, there are fairly strong economic arguments to be made. This is because prevention is almost invariably cheaper than a cure when it comes to a major surgical procedure (and/or the associated radiotherapy or chemotherapy in this factual matrix) with cancer as opposed to a major surgical procedure without cancer (and without the associated radiotherapy or chemotherapy). In a sense then, Blue Cross would have been unjustly enriched if they did not have to pay the cost of the surgery because they would likely have had avoided having to pay for the higher cancer related courses down the road if Katskee had not undergone the treatment in the first place.


It is further submitted that such economic cost-benefit analysis is particularly justified seeing as how our examination is that of a private enterprise and this is a readily identifiable quantification.


It will not be denied that this cost calculus changes if, as in the hypothetical facts given, Katskee’s family history is in fact not characteristic of early onset cancers. In which case, the immediate argument above suffers given the market of heath insurance i.e. short-term with high turnovers, as it will not be Blue Cross that is unjustly enriched but whichever health insurer that Katskee would be under during the time she would have had suffered the cancers.


However, in contrast to this monetary balance, it is worth noting one of the reasons on which the court bases its eventual holding is that “the diagnosis may encompass symptoms of anxiety and stress, which some women experience because of their knowledge of the substantial likelihood of developing cancer”.[11] And it can be said to lose sight of the individual in a system, particularly that of health care runs contrary to the its entire notion. And further, one might well argue that it would be cruel to withhold an early treatment on the basis that it is not cost-effective.


In the end, however, these argument probably do not change the outcome of the case. Legally, the test of whether a “condition which itself constitutes a predisposition to another illness is necessarily an illness within the meaning of an insurance policy”,[12] is not when the eventuality occurs but where it is “so remote in its potential mischief that common speech would not label it a disease or infirmity”.[13] Therefore, the lack of an early onset is not a bar to recovery for the preventive surgery.


Personally, the crux of this issue as this author sees it is whether this early surgical intervention is “the most medically appropriate treatment available”. As long as it is, the relatively lateness of the onset ought not to be a factor. And in addition to that, one might well imagine how it could readily be imputed into the overall calculations as to whether it is indeed “the most medically appropriate treatment available”.


Thus even if it should be economically unfair and disadvantageous to this particular insurer, as it might well be given the reasons above, and even should adverse selection occur such that the cost of premiums rises across the pool, this is an acceptable price to pay given the long term societal good that is being accrued through early prevention and intervention. And if as a result consumption of insurance falls, then it falls to the government and in particular their role to encourage societal optimal consumption through subsidies if need be,[14] especially where there is long term benefit to be gained.


In contrast, for patients like Karen Schmidt,[15] whose medical histories serve as indirect evidence of their genetic information, their exclusion is variously either “fair” or “unfair” depending on the viewpoint from which one analyzes the situation. For example, if one considers her situation in vacuo, it is not necessarily unfair discrimination given the bases on which the insurance company operates on. On the other hand, if one takes into account existing laws against genetic discrimination and the manner in which the market for health insurance works, then it is definitely unfair vis a vis her opportunities in relations to a) others with an equivalent health risk in pure genotype without her medical background and b) the discrepancy in terms of health disclosure between group health and private health insurance.


To return to definitions, Rothstein/Anderlik define “unfair” discrimination (as subsumed by their categorization of what constitutes genetic discrimination) as “drawing a distinction among individuals or groups plus an element of either irrational or socially unacceptability or both”.[16] In contrast, Rich/Ziegler would simply distinguish between fair and unfair discrimination on the basis of whether it is reasonable and lawful.[17] They believe that “insurance discrimination” to be lawful because it does not flout the Equal Protection Clause under the 14th Amendment of the US Constitution on its face, or the judicial interpretations of that Amendment.[18] And they see it as reasonable on the basis that risk classification is perfectly rational within the insurance community and in fact essential to prevent asymmetric information leading to adverse selection and the potential injury not simply to the industry itself but to healthcare in general.[19]


Adverse selection refers to a situation whereby the insured takes on a disproportionate amount of insurance, which is the result of the insurer not knowing what the insured knows and therefore cannot price the insurance premiums accordingly. This skews the market in such a fashion that the insurer would need to raise insurance premium rates across the board simply because there is no way of readily identifying such adverse selectors. And where adverse selection is a big problem as is with the case of anti-genetic discrimination laws, this then raises the incentive for insurers to crack down hard on any adverse selectors they may find and increases their risk adversity, particularly towards individuals.[20]


And thus it would appear that the key difference between the definitions by Rothstein/Anderlik and Rich/Ziegler is apparently that something that is societally unacceptable might still constitute “fair” discrimination because in this instance, adverse selection poses a big enough issue that societal disavowal of genetic discrimination ought to be set aside.


And since a history of breast cancer at 35 is probably a significant issue from an actuarial standpoint, therefore it appears as a reasonable basis as a criterion for discrimination. This is especially so coupled with the fact that her mother and sisters had experienced either breast or ovarian cancer, which was sufficient for her doctor to recommend genetic testing to determine whether she has a BRCA1/2 mutation. That unfortunate confirmation meant that it puts her at high risk of breast and ovarian cancer. This in turn places her at a fairly huge variance in terms of health risk from an otherwise “normal” female of her age.


So assuming that there were no genetic discrimination laws and further assuming that there were no difference in obtaining insurance coverage whether on an individual basis or through an employer, the exclusion of a patient like Karen is not necessarily unfair primarily because she did shop around for insurance. And it is on the record that one of the reasons why she applied to Fortis was the fact that the application only asked for medical history for the past 10 years, which allow her to truthfully withhold her medical history to a certain extent.[21]


But even in this hypothetical world it can be said that since the form was controlled by Fortis and it was well within their power to have extended the time frame for which medical conditions/consultations etc. needed to be disclosed but they made a conscious decision to limit it to ten years instead. Secondly, if insurers were free to treat genetic information just like any other form of information, we are probably less likely to see such need for evasive maneuverings primarily because it would be firstly a lot harder to get round a request for a genetic test for example, but much more pertinently, because of the reduced likelihood of adverse selection, companies will likely to be less restrictive in terms of eligibility and would simply price risk accordingly with premiums or with exclusions.


But in the current system, there is little doubt that Karen was subjected to “unfair” i.e. unreasonable, discrimination in totality, us taking into account the market structure, existence of genetic discrimination laws and the lack of a need for health information in obtaining coverage through an employer. The last factor of which is especially egregious because they is simply no rational explanation to lay a reasonable basis to distinguish the two situations.


Furthermore, Karen is in a particularly vulnerable state because of the existence of genetic discrimination laws. If, for example, she had not had her particular medical history but underwent genetic testing to determine her BRCA1/2 mutation, she could not be denied health insurance coverage under the HIPAA since it provides guaranteed enrollment for eligible individuals, regardless of their health status.[22] Or even for that matter the Wisconsin Statute on Restrictions on Use of Genetic Test Results which forbids, through section (1) and (2)(c) and (d), an insurer from using a genetic test from either considering eligibility or condition rates or coverage on the basis of either a genetic test or what the results of those were. But instead under her current situation, she can be forced to reveal her genetic information indirectly through disclosure of her medical history and can thus be denied insurance. While difficulty in obtaining insurance does not necessarily mean impossibility of obtaining insurance, nevertheless, the comparison is startling in its likely effects.


This actually places her in a worse position then if such laws had never existed because of the market structure in healthcare insurance. Such a structure where the major costs to the company are short term medical expenses and wherein their customers purchase them only for a short term and with a resultant high turnover creates the increased problem of adverse selection vis a vis the anti-genetic discrimination laws because it arguably makes customers such as Karen much less attractive and it becomes in their interest not to take her as a customer, particularly when she was in the market for long-term health insurance.[23]


But at the heart of it, what makes her exclusion so unreasonable is that there was no need to actually rescind her insurance contract. After all, if insurance is the pricing of risk, the reasonable thing to do would have simply been to renegotiate the contract and basically raise the premium. This argument is strengthened if one of our criteria for what constitutes unfair is societal unacceptability and this at the very least, on balance, one such situation.


There is no denying that the entire insurance pool being made to pay higher average premiums as a result of adverse selection may well be economically unfair on the basis that the individual is subsidizing someone else’s risk and disadvantageous in the sense that it could trigger a spiral that could well destroy the entire industry because every rise in average premiums causes more people to drop out which in turn forces higher average premiums.


At this juncture, an interesting question may be raised: “Is Schmidt the mirror image of Katskee?” by virtue of the fact that when Fortis rescinded her insurance coverage, they are doing so ostensibly on grounds of her phenotype even though in actuality it is very likely that the real reason was her genotype. After all, the remedy sought by Fortis was that of equitable rescission on the basis of a fraudulent misrepresentation i.e. misrepresenting that she did not have a history of breast cancer and treatment, which is her phenotype. Yet it must be that their real concern is that of her genotype or more accurately her future risks, because if her genotype were not at issue, there would be no real reason to rescind her contract since after all an insurance company is primarily profit oriented and if priced right, every contract represents profits for the company.


But regardless, it does cast doubt on the sustainability of the genotype/phenotype distinction as the definitional determination of genetic discrimination except insofar as it pertains to pre-employment or pre-insurance coverage. Instead, once insurance coverage is had, the definitional distinction ought to give way to the functional distinction in order to effectuate society’s beliefs on why genetic discrimination is impermissible.


What Karen’s case represents is a challenge to genetic exceptionalism in insurance, this idea that genetic information is somehow fundamentally different from other forms of medical information such that it warrants special protection, primarily through anti-genetic discrimination laws. The danger of this approach is that it in fact creates a form of medical underclass, a class for whom truthful information garnered by lawful means provides insurers with their genetic information. One solution may further extend the ambit of protection to patients like her. However, that in turn fundamentally undermines the notion of genetic exceptionalism, which has a cascading effect on genetic anti-discrimination laws in general.


While it is tempting to conclude that such a situation remains rooted in the peculiar health care system within the United States of America, it is worth bearing in mind that where in other states where health care is socialized, then the issue of genetic discrimination revolves about life insurance instead. This debate is not likely one to subsist anytime soon.

[1] Mark A. Rothstein & Mary R. Anderlik, ‘What is Genetic Discrimination, and When and How Can it Be Prevented’ in Kuszler et. el., Genetic Technologies and the Law, (Caroline Academic Press, 1st ed.), p. 91-94

[2] Ibid, at p. 91-92

[3] Supra n. 1 at p. 92

[4] Ibid.

[5] Ibid.

[6] 515 N.W.2d 645 (Neb. 1994), extracted in Kuszler et. el., Genetic Technologies and the Law, (Caroline Academic Press, 1st ed.), p. 202-208

[7] Ibid., at 203

[8] Supra n. 6 at p. 204

[9] Supra n. 6 at p. 204 - 205

[10] Supra n. 6 at p. 202

[11] Supra n. 6 at p. 206

[12] Supra n.6 at p. 207 citing Silverstein v. Metropolitan Life Ins. Co., 171 N.E. 914 ([N.Y.] 1930)

[13] Ibid. per Cardozo CJ writing for the court

[14] As is the case for primary and secondary education, which tend to be under-consumed in a free market.

[15] Schmidti v. Fortis Insurance Co., 349 F. Supp. 2d 1171 (N.D. Iowa 2005), extracted in Kuszler et. el., Genetic Technologies and the Law, (Caroline Academic Press, 1st ed.), p. 170-190

[16] Supra n. 1 at p. 92. Although as previously mentioned, they accept that society accepts discriminations that are irrational but might well condemn discrimination that are rational

[17] Robert F. Rich & Julian Ziegler, ‘Genetic Discrimination in Health Insurance for a (Not So) Special Problem?’ in Kuszler et. el., Genetic Technologies and the Law, (Caroline Academic Press, 1st ed.), p. 213-239

[18] Ibid., at p. 214 citing Lindsley v. Natural Carbonic Gas Co.

[19] Supra n. 16 at p. 215-216

[20] This is to account for companies that might specifically target high risk groups or the so-called state subsidized non-profit “high-risk pools” which seeks to bridge the gap between very high premiums that these people can’t afford or are simply rejected outright

[21] Supra n. 14 at p. 173

[22] Supra n. 16 at p. 225.

[23] Supra n. 14, see fn. 1 at p. 171

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Tuesday, February 06, 2007

Economic free fall in Zimbabwe - International Herald Tribune

Where good news may actually mean things getting worse

Humans are cognitively remarkably efficient machines i.e. we perform a lot of activities, even ones purporting to require loads of attention and concentration is actually very little of it. Devotion to details simply means that everything else is ignored.

As a result, given the really limited capacity that we have to be pay to pay attention to any number of issues at any one point in time (or sequence of time), Zimbabwe has fallen by the way side simply because of Worse Things Happening (TM) read Sudan, Rwanda, Ethopia - Somalia and of course everyone's favourite official stupidest war Ethopia-Eritrea (I probably shouldn't be too hard on the Ethopians because they did clean up the Somali Islamist situation. They seriously get no respect despite the fact they could kick most of their neighbours in a war).

So one might well wonder, given decades of political oppression, an entirely screwed up land redistribution policy resulting in a collapse of the agricultural industry and turning a net exporter into a net importer, using starvation and beatings as a political weapon and a economy in the doldrums, how could it get worse?

Well, we now know that the economy is in a free-fall. The sort of hyper-inflation that caused the collapse of the Weimar Republic, except in this case, an brutal autocratic regime is already in power and made a mess of things.

Wonderful.

Maybe I'm being overly optimistic. Despite a textbook example of state sanction and state sponsored genocide in Rwanda, people stayed out and the Press Secretary went into this darkly hilarious attempted explanation of how many acts of genocide constitute genocide in toto. Corpses were floating down river for goodness sake and the international community was so paralyzed that they could not even launch a medical mission to fish them out to prevent pestilence downstream. Same for Sudan where it was actually a big deal for one of the P5 to call what was happening there genocide.

So why would we consider the total collapse of Zimbabwe to bring any help from the international community? Well the situation in Africa is settling down and maybe a disaster on a big enough scale will either prompt the domestic government to open up or the international community to step in (mass refugee crisis constitutes a threat to international peace and security so technically the SC could launch a humanitarian intervention).

Or so one could hope.

Sunday, February 04, 2007

(muahahaha)

i knew those 8 years in christian schools meant something...

You know the Bible 93%!

Wow! You are awesome! You are a true Biblical scholar, not just a hearer but a personal reader! The books, the characters, the events, the verses - you know it all! You are fantastic!

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Friday, February 02, 2007

You know the Bible 69%!
 

Wow! You are truly a student of the Bible! Some of the questions were difficult, but they didn't slow you down! You know the books, the characters, the events . . . Very impressive!

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Dang....kinda sad. Granted that I'm not a Christian much less cracked open a bible in more than a decade but I thought I might have scored a bit higher. I had too much problems with the who beget who questions.

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