Hard News: Approved by lunchtime
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Background on the communications between the MoH and Helen Kelly's oncologist.
It's interesting, but the vibe is it was offered to the journalist because it makes the ministry look better.
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Bart Janssen, in reply to
It’s interesting, but the vibe is it was offered to the journalist because it makes the ministry look better.
I don't think anyone thought Helen Kelly wasn't at least aware of the political importance of her application. I got the feeling that the article somewhat overstated the political motivations.
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Sacha, in reply to
So her oncologist wasn't well-enough informed to realise that Sativex would not do what she wanted? A system that relies on that group of practitioners for information won't work then. Imagine if there was a national health organisation that hired researchers and policy people ..
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BenWilson, in reply to
I tend to agree with Bart about this one, Matthew.
I tend to agree with Matthew about this one, Craig. But it's typically cross-purposed, since we can have both evidence based policy and a democracy at the same time, if the democratically elected leaders (and/or the underlying public that elected them) decide to follow evidence, and that's probably something more like what both Bart and Matthew are arguing for.
But if the two come into conflict, I would most certainly not favour a system in which the opinion of a small number of people, even if they're scientists, however informed, could trump the political will of the people. It's hard to imagine a system which would more rapidly degrade the impartiality of science, and undermine it. It would no longer be an opt-in system, it would lose the internal power it has that struggling factions are allowed their go. Just as we separate religion from governance, so should be continue to separate the pursuit of scientific truth from it. For the good of the religion, and the pursuit of scientific truth, and governance.
There are plenty of situations, though, where it's practical to set it up like that. Medicine is one of them. It's obviously much more practical to have the large array of available drugs decided on by bureaucrats and medical scientists for the most part. But the overarching control should still be held by the people. Only they should set the parameters of moral right and wrong. The scientists constrain their activities to the parameters of evidentially true or false (well, more likely to probable and improbable).
Yes, this often leads to poor decisions. It does, however, protect against the worst kind of decisions. That's always been the main function of democracy, that it's a system that has a non-violent safety valve. Until I was convinced that a body of scientists had the same thing, I could not agree to allow it arbitrary control over the laws of my country. I'd need to understand that it's internal organizational structure was essentially aligned in the same way as the democracy in the first place, with it's source of moral principles coming from the people it stood for. Maybe it works that way now, if so, I'd like to hear the details. But what it currently looks like is a meritocracy, and that's NOT the same thing at all. That's more like the kind of system that the catholic church used for centuries, and that's an example that should make it clear exactly what the failings of such a system can be like.
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Bart Janssen, in reply to
What Mathew was saying was it's Ok to make rules and laws that are wrong - because democracy.
And you are conflating science and the pursuit of data with the data itself.
At no point did I suggest a meritocracy or rule by scientists so arguing against that is pointless.
What I did say is that the democratically elected representatives are failing to do their job if they make laws that not based on facts, data and evidence. It's not complicated.
Making a law that makes compound X illegal based on a rationale that compound X is unsafe when all the data show compound X is safe is a failure by the democratically elected representatives to do their job.
Making a law that says compound X is illegal because use of compound X is culturally unacceptable is a different thing and may or may not be reasonable depending on the culture.
What I was simply saying and it is very relevant to the topic is that unless you specifically make the law then you should be using the data and evidence to guide the law making process. It really isn't that hard.
As for "the people" being in charge - well that sounds nice until you get a council deciding to remove fluoride from the water supply to the detriment of the public health - because they were democratically elected (and excluded all the public health experts from the vote because of conflict of interest).
As for scientists ruling the country - well it would be nice to have a minister for science who was scientifically literate at least.
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Russell Brown, in reply to
So her oncologist wasn’t well-enough informed to realise that Sativex would not do what she wanted? A system that relies on that group of practitioners for information won’t work then. Imagine if there was a national health organisation that hired researchers and policy people ..
For the system, Sativex's overwhelming virtue is that it's an approved, pharmaceutical-grade medicine, so it's easy to say yes to. And they did want to say yes. I knew that Stewart Jessamine had called Helen to try and interest her in applying for Sativex instead, and we now know that ministry officials had considerable contact with Falkov along the same lines. It's not hard to imagine how he might say yes.
There were problems with the product Helen wanted to use, but I don't think the answer is to try and persuade her to ask for another product that might not do the job but is convenient for the system. It would be better to create a register of products that met basic assay requirements, even if they're not pharmaceutical-grade. That, least, would stop people wasting their time applying for approval for products that have no chance of approval.
There's a broader need to develop some competence in this area, if only so that the thousands of people self-medicating have access to good advice.
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BenWilson, in reply to
What Mathew was saying was it’s Ok to make rules and laws that are wrong – because democracy.
I can't speak for Matthew, but I think this is an overly simplistic representation of his argument. It's more just a rejection of what you are saying is a straw man, that our social order should be formalized as a meritocracy (rather than being a vague meritocracy, on the definition of merit as the people see it). I accept your statement that this is not your argument.
What I did say is that the democratically elected representatives are failing to do their job if they make laws that not based on facts, data and evidence. It’s not complicated.
It's not complicated, certainly. But it is an opinion. It looks to me like a necessary but not sufficient condition of the job of a representative. It fails to take into account other parts of the job - the main one being to represent. But you address that with:
Making a law that says compound X is illegal because use of compound X is culturally unacceptable is a different thing and may or may not be reasonable depending on the culture.
And there's the conflict. That IS the case for this particular discussion. I agree that representaves should take data and evidence into account. They also should take their assessment of the culture into account (although again it would be much nicer if they could do THAT using data and evidence too).
As for “the people” being in charge – well that sounds nice until you get a council deciding to remove fluoride from the water supply to the detriment of the public health
Sure, I think they are making a bad call. But having "scientists" in charge sounds all nice too, until they decide to underfund, for example, teaching in the Arts, because they have a strong bias on that account. Then you've got no comeback at all and can't even vote the buggers out.
But I don't think anyone is arguing for either extreme case anyway. Neither democracy that ignores science, nor science that ignores democracy.
As for scientists ruling the country – well it would be nice to have a minister for science who was scientifically literate at least.
Yes, just as the Minister of Magic should probably be a wizard. And definitely should NOT be the Prime Minister. For similar reasons that the Prime Minister should not be the Minister of Finance.
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Bart Janssen, in reply to
It looks to me like a necessary but not sufficient condition of the job of a representative.
So ... you agree with me that our representatives need to take into account evidence when they make laws.
Dude that's all I want and that's all I said.
The problem with the laws around cannabis is they are framed as public safety laws and public health laws. If they were instead framed as public morality laws, which is what they are since they ignore data and evidence, then fine.
At that point I can say I think they are stupid but I live in a democracy and the majority are fine with that.
However if those laws do harm ...
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Russell Brown, in reply to
Yes, just as the Minister of Magic should probably be a wizard.
I'd never thought about this before, but you're right.
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Not quite (and Bart didn’t ask for exactly that level of knowledge either):
“being scientifically literate” does not imply “having direct experience of being a working scientist”, in much the same way as
“being competent to understand and adjudicate uses and results of magic” does not imply “being able to cast spells”. -
Matthew Hooton, in reply to
I can’t speak for Matthew, but I think this is an overly simplistic representation of his argument.
I'm not really making a big passionate argument. Just that there are some things that can't really be evidence based, such as funding the arts, or Rugby World Cups or much of what we do in foreign policy - us sending soldiers to a dispute or introducing a climate change policy isn't going to be decisive. But we may choose to do these things anyway because we value the cause.
But "evidence based" also raises the question of whose evidence to consider and whose lens to use to interpret it. In a decision over whether to support a foreign request to support a military action, is it the evidence and lens of the realists, the institutionalists, the feminist theorists, or who?
I'm not making any bigger a point than that: that value judgements always need to be made.
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Sacha, in reply to
But "evidence based" also raises the question of whose evidence to consider and whose lens to use to interpret it.
Agreed.
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Russell Brown, in reply to
in much the same way as
“being competent to understand and adjudicate uses and results of magic” does not imply “being able to cast spells”.I am enjoying this argument.
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BenWilson, in reply to
“being scientifically literate” does not imply “having direct experience of being a working scientist”, in much the same way as
“being competent to understand and adjudicate uses and results of magic” does not imply “being able to cast spells”.No, but it sure would help.
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BenWilson, in reply to
So … you agree with me that our representatives need to take into account evidence when they make laws.
Absolutely. But what actions that "taking into account" leads to are far more complex than just taking the advice of whoever produced that evidence. In the same way that a courtroom judge should certainly take expert testimony into account, but is still the person who has to judge whether the law has been broken and what an appropriate sentence might be (in the case of judge-only trials).
In other words, I'm saying "evidence based decision making" != "scientists make the decisions". But you were never saying that anyway. It was more "scientists should always have input into the decisions that are about scientific matters'. On that I have no argument.
Bringing it back to this discussion, I simply read Matthew as rejecting the idea that scientific evidence alone would be a sufficient basis for legislation. It was probably a straw man, but that doesn't make it any less true. We still have to make judgment based on that evidence, and the judgment might not be to the liking of the scientists (or whatever other expert source we choose instead), since the way they would then act on the evidence is based on their values, and these may not represent society at large.
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Mr Peter Dung
Minister of Bums on Seats
The Beehive
WellingtonDear Mr Dung
Your application for a special dispensation to prevent a citizen of New Zealand from freely smoking whatever substances he wants to smoke in his own home has been DECLINED for the following reasons:
1) Not enough detail.
2) Everyone thinks your bow ties are ridiculous.
3) YOU work for US, not the other way around.
4) Please just get out of our lives you pompous, self-absorbed, utter utter git.If you would like to appeal this decision you have one (1) working day to do so.
You may submit a new application to prevent the same citizen from smoking whatever the fuck he wants, but a mandatory 10-year stand-down period applies, beginning from the date of this letter.
Regards;
The citizens and taxpayers of New Zealand
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Bart Janssen, in reply to
But what actions that “taking into account” leads to are far more complex than just taking the advice of whoever produced that evidence.
Which is true sometimes.
Where I get grumpy (alright grumpier) is the idea that 95% of the scientific community is say X, but Mr Concerned of Mt Roskill presents unsupported blog to the contrary and for some bizarre reason that must be given equal weight by our MP because [insert insane reason here].
That's why trolling me about climate change and liberal feminists will make me really pissed off.
And while I know you are talking about the genuinely grey areas where I really have no issue with considering all the opinions - that is all too easily translated by the trolls into "hey I found this farmer who said the water in his river was just fine so we can ignore Mike Joy and all his data".
Also in this age of equality we should allow witches to be minister of magic too - it would save money on domestic airfares too.
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Chaps, if you've concluded your learned discussion here, could you pop over to today's post and assess the new New Zealand Drug Harm Index for me?
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BenWilson, in reply to
Where I get grumpy (alright grumpier) is the idea that 95% of the scientific community is say X, but Mr Concerned of Mt Roskill presents unsupported blog to the contrary and for some bizarre reason that must be given equal weight by our MP because [insert insane reason here].
For sure. But when it's 1.5 million Mr/Mrs Concerneds it's a different matter.
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Take this
it’s Ok to make rules and laws that are wrong – because democracy.
and add
Is your political ideology in your head?
The differences between conservatives and liberals may be psychologically fundamental
...
The research, led by the University of Nebraska-Lincoln's Mark Mills, revealed that negativity bias -- where greater weight in our cognitive processes is given to negative information over positive or neutral information -- is stronger in political conservatives and that the negativity bias transfers to how well they remember stimuli.
In other words, conservatives in the study were more likely to remember things that evoked negative emotions -- images of war, snakes, dead animals -- than their more liberal counterparts.https://www.sciencedaily.com/releases/2016/03/160331105728.htm
Could explain a lot...
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Reference posted in the drug harm index thread, copied here as being equally relevant to this thread: Psychadelic Science
a BBC Radio 4 program asking, basically, whether anyone is competent to understand and adjudicate uses and results of magic mushrooms:Jamie Bartlett asks if new research into psychedelic drugs will lead to them being accepted as mainstream medical treatment – or whether their controversial history will prove insuperable.
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