Alienation’s Apotheosis

There are some presentations at our second cohort at the biomedical ethics residency today that made me queasy because of how backwards causation they were. The whole point of having biomedical ethics is to avoid blinding ourselves to the various factors that create the need for medicalization and individualization of the common(s) problems we face with health and illness.

I’m going to say something that might be hurtful to people’s feelings because it might undermine a large part of their career as fruitless or misguided. If you look at East Germany how child rearing was done, you don’t need to imagine how artificial wombs may make people’s lives better – you just need policies that support women. It’s pretty simple.

Some people actually believe that artificial wombs would be more ‘just’ for women. Your ‘product’ would no longer be a human being. And you would no longer have a mother. Is this really the only direction science can take us? Towards dehumanizing ourselves (biologically, ecologically, socially)?

The problem is of course that so many people believe that it’s impossible to actually have a political and social system that supports women that instead they are going to blow up the entire earth in the whole universe in order to make that work around. This logic of the workaround which is so central to most of our technological developments is an industry ploy to not confront that which needs to be confronted, whether it’s perversions of religion the state or our dysfunctional social system.

Unless and until we re-gain a sense of the sacred in our lives and in life, we will not be able to make good decisions, but will keep on doubling down on suffering in ways that we can’t even be aware of. Instead of throwing technology at our problems, as if this technology didn’t arise from our own twisted mentality, and could somehow break free from our own contorted mind, we need to work on addressing the traumas and us individually and collectively which gave rise to the problems for which that technology would have been desired in the first place.

The Tech Megamachine

As annoying as I find Russell Brand on occasion, in this case he makes a good point. The marriage of corporate and state power – technology and the monopoly on violence – which Mussolini called ‘fascism’ and Lewis Mumford called the megamachine, is getting closer and closer to a totalitarian checkmate the likes of which Hitler and Stalin could only dream of. While the purported ends of this power is far different (we hope) in putative democracies than for those dictators, it behooves us not to throw out Lord Acton’s admonition about absolute power corrupting absolutely.

That is to say, even in the best case scenario of enlightened despotism, good people can easily become quite unenlightened and arbitrary despots when shoehorned into the role. Or to modulate parlance, Marshall McLuhan understood the hubris that comes with the ability to manipulate. The mediums of communication and expression aren’t only constraining on the degrees of freedom for those bound by them, but also for those who construct them. When all you have is a hammer, everything becomes a nail. When access to more data must be justified through results, then more and more events must be legible as actionable. Otherwise, the justification for such police powers is anemic, and easily refuted, with legitimacy possibly undermined. Thus, technologies of surveillance and violence themselves must give rise to more cases that allow the opportunity for violent intervention, or else risking their claim to providing actual services in the public’s interest.

The Ring commercial Brand reruns here is a classic case of what Andrew Szasz has critiqued as building up a personal commodity bubble. Instead of, like any addict, acknowledging that we have a problem, and then working with others maturely to solve it, Amazon’s Ring video doorbell surveillence system markets an exclusively individual solution to what is in reality a preventable collective action problem. Ring’s commercial pitch goes like this: If there are robbers, keep them moving along, not so that they can improve their lives, and change professions, but so that instead of robbing you, they go rob your neighbor’s house!

Such galimatias attempts to gaslight you into thinking that it is inevitable that we live in a fundamentally unsafe world. Because if we believed that we could live in a safer world, we might be able to build that world. And you can bet, that world would not require as many cameras or police.

This gets to the heart of why Ring’s preying on nebulous fears which are brought on by the megamachine itself is so successful as a ploy. Because of the manufactured stochastic crime created by an every-man-for-himself system without safety nets or a healthy welfare state, inequality breeds both blue-collar crime (the type we’re all made to be afraid of) and white collar crime (which kills millions at a time through enforced poverty, impoverishing our environment, and harming our health behind the scenes). This is not to minimize the trauma to people of actual violent crime or thievery. Instead, it is to say that all of this is preventable – and not just by playing an arms race (or evolutionary treadmill) with robbers. Getting smarter systems just makes robbers get smarter, and the same amount of crime occurs.

Amazon’s wish is to make it so that only those opting out of their private neighborhood watch program get robbed, because they will be easier targets. So those opting out for moral, religious, or financial reasons from their racket then become left out of their ‘protection,’ and the insinuation goes, become the targets of least resistance.

“No, I think you’re in the wrong place.” As the video shows, the idea that would-be criminals are only in the “wrong place” rather than needing help for reform and redemption, cements the trope of cleverness. I’m clever because I have the Ring alarm system by Amazon, so I get off fine, but that poor schmuck down the street, well, he’s screwed. Such notions reinforce the tech megamachine, where you keep on having to buy into the racket because crime is inevitable, and just don’t let it happen to you. It is, what Davids Graeber and Wendgrove call a “failure of imagination.” It is capitalist realism, or crime realism, where those evil people out there are uncorrectable, and just bad people, rather than just victims of a broken system. With such pathological thinking comes the inevitability that crime stays constant (or increases, especially in election years!). Manipulating perceptions of crime, and stripping away access to human dignity so things feel more precarious for everyone, is the perfect catfishing for expensive subscription services of mass totalizing surveillance that Foucault could only dream of.

I’d be interested to see data on how many false positives Ring delivers to police; how many times the cameras have been hacked by perverts; how many times leaked clips of children playing have appeared on dark web sites; etc.

Ring touts itself as “Neighborhood Watch for the digital age.” There’s a long, racist history of the invention of Neighborhood Watch programs springing up in response to de-segregation and the policing of white spaces, which continues today. Shawn Fields’ excellent new treatment of this history discusses the abuse of emergency response systems, which rarely fight crime, but often lead to unwarranted police violence.

Time to Clear the Air on EUR Smokefree Policies

From Erasmus Magazine’s misrepresentative title “Smoke-free campus: responsible decision or counter-productive?” for the very pro smokefree campus comments from students actually interviewed in the article to the irresponsible and juvenile “Free to Smoke Zone” cartoon, it appears that more than sentiments of staff or students, it is Erasmus Magazine itself which is against the inevitable. A national law prohibiting smoking on the campuses of all institutions of learning countrywide, EM’s attempt to foment controversy where there is little, is either just clickbait or jousting at windmills

smoke_free_campus_illu


Granted, EUR could have done better at communicating the law and what that means for students. This would have happened normally, but we are not in normal times.


Furthermore, there are a number of structural issues preventing a smooth transition to the current regulations. For example, at EUR there are no experts on tobacco control in the Smokefree Working Group. Only recently did the university form a “think tank” as an afterthought to address this oversight. In not putting the science of going smokefree on campuses first and foremost, the university has abdicated its responsibility to be science-based in its policy making. Instead, in shying away from actually affective, clear, and unambiguous actions, it is setting itself up to fail on every dimension. Lack of clear communication of the new rules and support for smokers is bound to make some smokers angry because they won’t know the details, and it won’t be clear what the rules or penalties are. EUR’s delay on this issue will also make nonsmokers upset because the national law says that people can’t smoke on campuses of educational institutions but EUR has not yet effective achieved, based on a cowardliness to stand behind clear and fair preventative measures and penalties. And EUR may even fail to comply with the national law, which could cost our university fines from the government, bleeding our university unnecessarily, when we have already suffered budget cuts. Plus, EUR’s potential failure to comply with laws sours our reputation versus business and governmental partners with whom we might pursue future contact.

Especially in times of corona, which is a respiratory disease, smoking will only make it worse. If we have social distancing on campus, lowering the quality of education and costing faculties untold hours of suffering in adjusting to the double responsibility of hybrid education, then we must certainly do our due diligence in not creating more disease vectors on campus. If we’re wearing masks to prevent viruses from entering our nasal passages, it makes only sense to get rid of non-essential pollution sources that weaken our immune system and predispose us to sickness. 

The Failure of COP25

I recently read – from afar – the sorry state of the UNFCCC #COP25 in Madrid. According to 350.org, instead of barring fossil fuel companies from engineering the COP, the security guards at the UNFCCC forcibly removed hundred of activists and scientists who aimed to bring gravitas to an otherwise hypocritical and superficial discussion.

LIVE feed from the #COP25 UN climate meeting pic.twitter.com/KukPvMAtVx
— Dr. Lucky Tran (@luckytran) December 15, 2019

The de-badging of climate activists, who refused half-measures and rhetoric as adequate given the current hundreds of billions if not trillions of dollars of damages each year due to corporate- and government-induced climate chaos and decades of enforced ignorance, is not surprising–but it is the first time this has occurred on this scale at the UNFCCC.

As The Onion burlesques the denialism,

In response to the attention she was receiving for her vocal objections to international leaders’ refusal to address global warming, critics in the 2030s asked why teen climate activist Elisa Garcia-Reilly wasn’t in an abandoned school bailing water and shooting enemy foragers. “Instead of constantly screeching about how all our policies are selling out her generation and dooming them to unavoidable suffering, maybe this little hussy ought to spend more time in the remains of what was once a high school choosing which infants to save and defending her family’s food cache from scavengers,” said television pundit Caden Williams of the 16-year-old climate activist, voicing the sentiments of critics who declared that she had no clue what she was talking about and was trying to catastrophize being constantly starving and up to her waist in water.

A cinematic cityscape depicting a destroyed city.

Having myself attended the UN World Summit on Sustainable Development in Johannesburg, South Africa, in 2002, in an action with AdBusters, I too was de-badged as US representative to the meeting Colin Powell obfuscated effective action. That was 17 years ago. Things have gotten even worse since then, and now climate chaos is felt in every part of the world.

The question remains: what will it take before we prioritize life over profit?

Will the currents have to stop? Massive crop failures from extreme weather events? Heat waves that kill millions? Dikes cracking from prolonged droughts? Wild fires destroying trillions of dollars of real estate? The end of business as usual as commodity chains break down?

The problem is, in our current system, there simply is no circuit breaker. There is nothing that could happen – within our current dominant mindset – that would force action. It’s like the person bleeding profusely who swears they’re healthy until they fall over and die, instead of getting the help they need and interceding on the “inevitable.”

This clip is an apt metaphor for Capitalist Realism.

Climate chaos is a spectrum. The more we double down with ignorance and denialism, the worse it gets. The sooner we clean up our act, the less possibility that doomerism will be correct. The irony of deterministic ideas such as “Well, we destroyed the climate, so might as well enjoy the luxuries before they’re all gone,” is that the path is made by walking. Yes, we have created since the industrial revolution, a tremendous amount of path dependency, creating ozone holes, the 6th great extinction, and making life on earth very difficult for the next hundred (or thousand – our choice) years.

But, what we do now crucially influences whether we get to keep some of the goods of human civilizations while jettisoning as soon as possible the bads; or, if we take out the majority of complex life on earth out with our species. It’s our choice. But it requires completely reorganizing society according to our interspecies interdependence, and revere the processes of nature which human artifice and systems of control and domination have swerved into dysfunctional and perverse fragmentation.

Fuel emission standards

Who is fueling the Alice in Wonderland media world which slowly is infecting and deceiving people around the world, spreading the ignorance virus?

Let’s take the way that Trump wanted to roll back the Obama-era federal fuel emission standards as an example. While Trump and the oil companies thought this would be a marvelous idea, to stick it to the liberals, so that we’d waste more oil, astonishingly the four biggest auto manufacturers were opposed to this, as they had already begun producing cleaner cars, and other big markets like Europe have similar fuel and pollution auto standards, so going Neanderthal in vehicle fuel and emissions standards didn’t make sense. It was a big surprise to the White House, apparently, that creating more pollution and costing individuals more to fill up their tank didn’t work, even with auto manufacturers. What a surprise for Trump and Co. to realize that even pandering to the worst possible arguments didn’t work. Then 4 of the largest automakers and the state of California made a pact that they would uphold the previous Obama-era emissions standards and fuel targets. Because it made good business sense. (Nevermind the fact that it saves consumers hundreds of billions of dollars and reduces pollution).

The New York Times somehow thought it fitting to ask the Trump Whitehouse to weigh in.

“Unfortunately, California is trying to impose its failed policies on the rest of the country by making new cars significantly more expensive for American consumers and less safe,” said Russ Vought, the acting director of the White House Office of Management and Budget, in an emailed statement. “Even worse for Americans on the road, a handful of irresponsible automakers are aiding California’s radical agenda that will hurt every one of us.”

https://www.nytimes.com/2019/09/05/climate/trump-auto-pollution-california.html

This completely up-is-down-and-down-is-up response, which is about as far away from reality you can get unless some giant loaded you in one of those dog ball-throwing launchers and whipped you into a few galaxies down the lane, not only reaffirms that US Government has become a premier propaganda machine, in their attempts to rival North Korea and China, but also shows how the New York Times is working for the same corporate masters. Why? Two reasons.

First of all, the dumb idea to force California to not enforce it’s laws is a non-starter. What ever happened to states’ rights? Oh yeah, that was only a corporate tool, and to gain libertarian votes and then give them the finger. Classy, tea partiers and Koch Co.

Second, there’s the fact that California will not comply with unreasonable federal the-sky-is-falling threats. Sorry, California is the world’s 5th largest GDP, you can’t push it around like that. We control your freaking internet ;) But why is the NYT giving more platform to the Competative Enterprise Institute, a well-known rabid racist, misogynist, and overall ahistorically-inclined corporate front-group? There are a million intelligent people to interview about how laughable this proposal is, how the Trump administration will never achieve this, and that it’s just shirtcocking posturing from Mr. smallfingers. But no, the NYT goes for its one interview with the humpback goon of Trump. Great balanced reporting, right there.

Of course,

“The Obama-era tailpipe pollution rules that the administration hopes to weaken would require automakers to build vehicles that achieve an average fuel economy of 54.5 miles per gallon by 2025, cutting about six billion tons of carbon dioxide pollution over the lifetimes of those vehicles. The proposed Trump rule would lower the requirement to about 37 miles per gallon, allowing for most of that pollution to be emitted.”

https://www.nytimes.com/2019/09/05/climate/trump-auto-pollution-california.html

And of course,

“Xavier Becerra, the California attorney general, restated his intention to sue over any attempt to undermine his state’s legal authority to set its own pollution standards. “California will continue its advance toward a cleaner future,” he wrote in an email.”

https://www.nytimes.com/2019/09/05/climate/trump-auto-pollution-california.html

San Francisco BART’s Unpleasant Design

Introducing: The inverted guillotine

Having lived for the better part of my life in the San Francisco Bay Area, I have put in my time on the Bay Area Rapid Transit (BART) system. From it’s loud, overcrowded, clunky, and infrequent trains, to the spate of BART police shootings of young men of color, this privatized (militarized?) operation has a monopoly on public transport, and unashamedly has its will with the region with little grace.

The latest offense is the instillation of “skull crusher” “inverted guillotine” pop-up spring-loaded barriers, that could hurt or maim (it’s just a lawsuit waiting to happen).

Instead of pouring money into education, or helping the homeless, the Bay Area has now apparently prioritized metal spikes shooting up from their BART turnstiles. Way to go, gentrification!

The fact that “fare jumping” is solved by violence is telling. Instead of maybe just making the BART – a public service – into a public company, free for all riders, payed by a corporate property tax (or some other public funding in the insanely overpriced Bay), as many other localities such as Tallinn in Estonia have done, doubling down on menacing design elements further marginalizes the marginalized. BART really doesn’t lose much money at all on fare jumpers. Their financial mismanagement is sui generis. Yet, like all administrative classes, the propensity to pay themselves more to harm the poor is too tempting; it exculpates their responsibility for mismanagement (and points to the need for the region to re-buy the service to run it correctly), and instead finger-wags at “scofflaws” for being bad people, when all they really are doing is what is necessary to get around their own town when they haven’t benefited from the Silicon Valley boom.

The book Unpleasant Design discusses the epidemic of public infrastructure that makes being in public an injurious experience for those worst off. From bus benches in shelters that slope so you can’t sleep on them (you’d fall off), to “anti-homeless spikes,” sonic warfare (projecting odious or repetitive noises, like that corporately-engineered “hit” “Baby Shark“), ordinances against “sitting” or lying in public spaces for too long — rich countries, especially English-speaking ones, have declared war on public space.

London, UK. 10th June 2014. Anti-Homeless Spikes Protest outside Stock Photo: 70030582 - Alamy
Anti-homeless spikes

Unpleasant design takes what little of the commons are left – the nooks and the crannies – and puts money into destroying them to keep out “undesirables.” This racist and classiest action is often the result of gentrification; justified to keep the zoos of the rich free of those who can’t pay their entry fee.

These artists are tackling London's anti-homeless spikes head on
Activists in London combat the painful anti-homeless spikes

The psychological warfare of guillotine turnstiles makes the entire experience of public transportation less comfortable for everyone. Instead of dealing with the 80-20 principle that 80% or 90% of riders will pay no problem, and that there will always be a remainder of the population that for what ever (often very legitimate) reason cannot or will not pay, BART has chosen to harm the public, pushing more people into their polluting cars.

I’m sure before long, people will be defacing these violent turnstiles. And it is likely that the accumulated rage against BART will reduce paying ridership (despite their monopoly), actually bringing them less money than they had before–the exact opposite result than they profess to so-desperately and so-forcefully want.

The public outrage on Twitter is already loud and clear against BART’s weaponization of its service. Such aggrandizement activities miss the point of their charge: they are in the business in providing a public service, and some people can pay more, some less, and not at all. Perhaps peg BART tickets to income. Then the rich might pay $100 per ride, the poor the normal $3.40 trip, and the very poor nothing. That would be a fair approach. Our society is far from that enlightened thinking, sadly, even in that hotbed of *potential* San Francisco, Oakland, Berkeley, and environs.

But let’s not deceive ourselves. There’s a reason why you can’t take the BART to Marin County: racism. Back in the 1950’s there was a plan in place to extend the San Francisco BART to Marin (North Bay), but because of vocal refusal by residents, it failed. And now, no easy public transportation (besides the ferries) go to Marin. The Bay Area is disconnected by design, an open gated community in a natural and cultural paradise predicated on class, race, and exclusion.

Have we not evolved as a city in 70 years? Are we still just as violent towards those less fortunate than us. San Francisco is a mess because of its wealth. But at least on this case of BART structural violence, the people are having their day of reckoning.

Thoughts and Prayers and Regulations

There is an epidemic of thoughts and prayers in America. It seems the more politicians think and pray, the more school shootings happen, the more places of worship get gunned and burned down, and the more people die.

Maybe to reverse this trend, politicians need to stop sending their thoughts and quit praying, and instead begin doing their jobs: defending the commonweal against those who would sacrifice it for profit.

New PLOS Medicine Article on Addiction

PLOS Medicine just published an article I wrote with Jesse Elias and Pam Ling at UCSF on “Public versus internal conceptions of addiction: An analysis of internal Philip Morris documents.” This article discusses previously secret industry documents pointing at the disconnect between the Philip Morris’s public statements of addiction as reduced to nicotine, and their secret unpublished research showing that nicotine is a minor overall component of smoking addiction.

Public health researchers interested in helping smokers would do well to critically appraise the public statements, policies, and actions of tobacco and nicotine dealers, especially as these are strictly for-profit companies beholden to their lexical priority of fiduciary responsibility increasing shareholder value at all costs.

Rather than bandwagoning on nicotine determinism, addiction is a biopsychosocial disease with lobbying and advertising as disease vectors.

 

News media on the paper appears in The Outline and other interviews.

The Outline writes:

Publicly, Philip Morris has been willing to admit that cigarettes are addictive since 1998—but would only cop to the role of nicotine in forming an addiction. Yet privately, the company knew that social, psychological, and environmental factors are also central to addiction and how difficult it is to quit smoking. In other words, addiction was never just about nicotine, and Philip Morris knew it.

Gizmodo writes:

the researchers hope to remind public health officials that tobacco addiction is about more than just nicotine, and that there isn’t enough long-term data to show whether “reduced harm products” actually benefit public health. Even Philip Morris recognized this.

OnMedica writes:

In other words, they said, PM’s ‘opportunistic’ shift from denying to affirming nicotine’s addictiveness was driven not by a substantive change in scientific understanding but by public, regulatory, and legal pressures.

Inverse writes:

While Philip Morris publicly acknowledged nicotine’s addictiveness in 2000, the study’s authors suggest that the company scapegoated the chemical as the solitary driver of addiction. By placing the blame on nicotine, company scientists drew attention away from a potential public health focus on biological, social, psychological, and environmental factors that could help people quit smoking….

For addiction researchers, public health researchers, and smokers, it’s clear that smoking is about so much more than the nicotine. But this analysis suggests that a major tobacco company attempted to steer the focus toward only nicotine, decreasing the effectiveness of interventions that could help people quit.

Susan Mayor writes in the British Journal of Medicine writes that while PM’s “Addiction Consensus Group”:

Sounds very virtuous

More like a cover up. An analysis funded by the US National Cancer Institute compared the company’s public position on addiction with what was being discussed within company walls. It found that throughout the 2000s Philip Morris reinforced the idea that nicotine’s pharmacology was the main driver of smoking addiction. But internally, company scientists were saying there was bit more to it than that. Addiction was the result of “interconnected biological, social, psychological, and environmental determinants,” with nicotine just one component.

Airplanes and Death: A Study in Sound Pollution

 

I recently published an article in Berkeley’s newspaper, Berkeleyside, about the incessant overhead air traffic, and how this likely is causing significant public health effects.

Here’s the evidence  base:
https://www.ncbi.nlm.nih.gov/pubmed/25332277
https://www.ncbi.nlm.nih.gov/pubmed/22491084
https://www.ncbi.nlm.nih.gov/pubmed/26356375 “These significant associations were not attenuated after the adjustment for air pollution. The present ecological study supports the hypothesis of an association between aircraft noise exposure and mortality from cardiovascular disease, coronary heart disease, and myocardial infarction. However, the potential for ecological bias and the possibility that this association could be due to residual confounding cannot be excluded.”
https://www.ncbi.nlm.nih.gov/pubmed/20881600 “Aircraft noise was associated with mortality from myocardial infarction, with a dose-response relationship for level and duration of exposure. The association does not appear to be explained by exposure to particulate matter air pollution, education, or socioeconomic status of the municipality.”

The Irony of UC Priorities

Irony: UCSF sends employees an email warning of the thousands of people descending on Golden Gate Park to celebrate the annual 4/20 Cheech and Chong-inspired marijuana fest, but UC Berkeley sends out no notice to its employees and students that hundreds of violent racists and criminal neonazis were planning on gathering to incite violence and spew hate speech right in front of the waiting if complacently passive police in the heart of Berkeley.

Stoners = Dangerous?

Violent racist criminals = Safe?

#UCpriorities

 

image001

Dear UCSF Community:

On Thursday, April 20, 2017, thousands of people are expected in the east side of Golden Gate park near our Parnassus campus for an annual “4/20” event.

Heavy congestion is expected all day in San Francisco and surrounding communities on April 20.

Please consider taking public transportation, adjusting commute schedules, or telecommuting if your position and department allow.

In order to minimize travel, please consider scheduling meetings via WebEx or conference call.

If you must commute by car, please allow additional time if traveling to/from the Parnassus Campus. You can check local traffic by calling 5-1-1.

If traveling by UCSF shuttle to/from the Parnassus Campus, please expect delays due to increased traffic.

For questions, contact: Transportation Services staff at supportmycommute@ucsf.edu or 415.476.4646 (GOGO)

Cruelty?

Not sure what to make of this. I respect the Japanese and their culture on so many counts – but amphibians are intelligent, and this seems to be excruciatingly cruel. To not be able to identify other living beings as having an inner world of their own, to treat them as mere objects, or even to glorify their macabre treatment does not bring us closer to our own finest nature as humans. Rather, it allows us to start an in-group/out-group (whether that is other humans or other animals) bifurcation that allows us to be ceaselessly violent to anything (notice that they are now things instead of beings) that falls out of the in-group (of ____ like us).

Yes, certainly, there are certain automatic processes of the bullfrog, that once eviscerates keep its muscles twitching even though it is by some counts ‘dead’. But death is a limn rather than an automatic point; and we ought to respect the entire process, not just some arbitrary cut-off point where we decide something is dead, and hence disposable.