The Women’s Congressional Hearing (with apologies to Nellie McClung)

With apologies to the indomitable Nelly McClung

SCENE

[Interior of congressional hearing chamber. Behind a large and impressive wooden table sit three middle aged women in well-tailored suits, hands neatly folded in front of them.]

CHAIRWOMAN: Welcome, all, to this House Oversight and Government Reform hearing on the insurance coverage of erectile dysfunction medication and religious liberty. The chair recognizes the esteemed panel.

Today we are here to discuss the recent White House proposals regarding pharmaceutical coverage. The Obama administration wishes to force private insurance companies to provide coverage for erectile dysfunction medications. I’d like to ask the panel to provide an opening statement.

REV. CHASTITY: Thank you Ms. Chairwoman. The Obama administration has put a stranglehold on religious liberty in this country by forcing all Americans to accept practices antithetical to Christian doctrine – that is, that we should all pay for men in this country to be having recreational sex. The Bible clearly condemns sexual activity that is not for procreation – in Genesis 38:9-10, it stats “He spilled his semen on the ground to keep from producing offspring…What he did was wicked in the Lord’s sight.”

These men are sinful, and the people of America should not be held financially captive by the lustful, wicked ways of the godless left wingers of this country. Jesus said, “But I tell you that anyone who looks at a woman lustfully has already committed adultery with her in his heart.” We, as Christians, should not be forced by an overbearing government to fund mortal sins!

CHAIRWOMAN: Thank you, Reverend. I’d like to now ask the panel to comment on whether this medication could be seen to be medically necessary.

DR. PROSTATE: Oh, definitely not. Sexual activity is entirely optional. In fact, erectile dysfunction isn’t so much a medical condition as just a normal part of aging. Men have lived for centuries without drugs that allow them to have sex for purely recreational purposes and I certainly don’t see why they have suddenly been rendered unable of coping. Indeed, it seems that popular media portrayals of older men like Hugh Hefner as sexually active has lead to a move away from traditional values. There is really absolutely no medical reason why individuals would ever need to have sex beyond their child-raising years. It is excesses in the medical system like erectile dysfunction treatments that are sending health insurance costs skyrocketing.

I’d also like to preemptively counter the point that sometimes erectile dysfunction medication can be given for legitimate medical issues and say: the majority of erectile dysfunction drugs are given to people who want them for recreation, not people who need them. Sexually transmitted infections in elderly populations have been on the rise since the introduction of erectile dysfunction medications. Adding barriers to access will prevent people from being sexually active and prevent the spread of STIs. The best way to prevent erectile dysfunction is to abstain from sexual activity. Everybody wins and nobody needs to pay out of pocket for somebody else’s jollies.

CHAIRWOMAN: Thank you, Doctor. And now, could we have a final word from Senator McClung?

SEN. MCCLUNG: We have heard men speak out in support of the Obama administration’s proposed coverage, and although some may be well-spoken and seem capable, we must remember that men are ultimately weak at heart and easy to be persuaded into sexual activity by women and the media. Supporting the use of erectile dysfunction medications puts these vulnerable men at risk of being preyed upon by women, and promotes irresponsible usage of the medication. This could lead to promiscuity, STIs, unwanted pregnancies, abortions, and other horrors that plague our modern society. If I may be so bold as to paraphrase the words of my great grandmother:

If men were all so intelligent as these representatives of the downtrodden sex seem to be it might not do any harm to allow them access to erectile dysfunction medication. But all men are not so intelligent. There is no use in allowing men to have Viagra. They wouldn’t use it. They would let the pills spoil and go to waste. Then again, some men would have sex too much…Giving men Viagra would unsettle the home….The modesty of our men, which we reverence, forbids us giving them Viagra access. Men’s place is in the workplace, not the bedroom..It may be that I am old-fashioned. I may be wrong. After all, men may be human. Perhaps the time may come when men will be responsible enough to have sex with women for reasons other than procreation–but in the meantime, be of good cheer. Advocate and Educate. [adapted from Nelly McClung, The Women’s Parliament]

[Thunderous applause erupts]

CHAIRWOMAN: Well said, Senator McClung. If there are no further opinions-

LONE MAN IN CROWD: Wait, don’t we get to-

CHAIRWOMAN: I’d like to thank the expert panel for their time and we will await the committee’s decision.

[The hearing chamber noisily clears out.]

END SCENE

If you have no idea what this is about, read here. If you are horrified that the words of a suffragette 99 years ago resonate today as much as they did then, SPEAK UP!

Hear me ramble in other media!

For those of you who like hearing what I have to say and yet are simultaneously tired of reading my long-winded text blocks, here’s some fancy new ways to get your fix:

Check out my Skepticamp talk on the history of the relationship between science and the media, and how we can navigate it to parse the truth from the hyperbole!

And now that you’ve heart all about the problems of media, take some time to hear the good stuff! Give Life, the Universe & Everything Else a gander – I’ll be on the panel occasionally, just like I am in the latest episode discussing “What’s the Harm?” in alternative medicine. We’re the top “New and Noteworthy” podcast on iTunes in Science & Medicine, and also in the top 25 of popular Science & Medicine podcasts as of right now!

And hey, if you really can’t live another day without reading an Orac-ian block of text, I’m also blogging for Skeptic North now, where I’ve already been trolled for my post on the evils of pox parties and the lack of informed consent in the anti-vax movement.

Filler – so sue me!

So I know I’ve not posted anything in forever (since my first week of classes, as it turns out), but I just wanted to post a few quick things:

– As it turns out, being a medical student is rather time consuming. It’s not to say it’s quite as bad as some people seem to think it is, but I’m also living by myself, so keeping on top of feeding myself, doing yard work, cleaning house, etc. in addition to studying ends up eating up a lot of my time. So hence my lack of time to compose insightful, brilliant opuses of skepticism. Or you know, even the usual sort of thing I write.

– I don’t have TV anymore and I miss being able to watch Mythbusters. So I followed them all on Twitter. Tory was live-tweeting this Sunday’s episode where they were launching anvils into the air (via explosion, of course). Jealous, I tweeted:

I was maybe a little too excited when he tweeted back.

He made a very good point, and so I didn’t drop out. Yet. Tuition isn’t due until the end of September… so there is still time. Ha ha. Alternatively, I’m hoping they need a doctor on the set. I’d totally do it for free. I love science.

– I spent a lot of time this summer at the St. Norbert Farmer’s Market, and I’ve finally been annoyed enough by the various insane things being peddled there that I decided to blog about it. It’s a work in progress, but here’s some clues: negative ions, biofeedback subluxations, and raw diet. You would not believe how adamantly people buy into it. I actually unintentionally got into an argument about it with one of the customers of these people because they randomly came up to me and tried to convince me, too.

– I also have a lengthy piece on stem cells that I don’t know what to do with for the moment. It’s more educational than controversial – unfortunately but once again science demonstrates that there are no absolutes, and every answer has the caveat “…but it’s not quite that simple.”

– I have a scheduled, testable course lecture on CAM use in cancer coming up in October. It’s being given by the head of the local CAM institute, so I fully expect to have a plethora of blog material from it. It is our only scheduled CAM lecture, but fortunately we have a few vocal skeptics in the class, so it could be an interesting class.

– I am totally procrastinating on studying for my upcoming ominously looming midterm right now. I just thought you should know if you hadn’t figured it out.

Speaking of procrastinating, here's a picture of the grizzlies at the Calgary Zoo. Guess what I did on Saturday...

Skepticamp Winnipeg is coming up forthwith!  September 17th! Aqua Books! Come see all the interesting people give talks on nutrition, fallacies, polyamory, free will, perpetual motion machines… oh, and some pseudonymous blogger is doing a talk about Science in the Media (and how to find out the truth of things). I’m quite excited for it. Let us know that you’re coming here.

This is why we need women in skepticism!

There is a lot of post-Elevatorgate buzz about women in skepticism, including the announcement of a conference to specifically deal with women in secularism, more specifically the lack thereof. A lot of people who think that this is a non-issue have said that women (and other minorities in skepticism) will join the movement when they want to, that women simply aren’t interested in hearing about it. (And if you don’t think people actually believe this, please read the comments on the “Women in Secularism” announcement.) Since secularism is about self-improvement and education, I’m going to call Bullshit! on that. Yes, part of the problem is an environment in secularism that is intimidating to women, a lack of prominence for female skeptics, and so on. But the inverse of that is the amount of woo that is promoted to women.

Manitoba women use the health care system more than men, averaging 5.4 physician visits annually (4.4 for men), and 85% of women see a physician at least annually (79% for men.) Even healthy women of reproductive age receive birth control from their physician, have annual Pap tests, get mammograms, have prenatal consultations, and use health care services before, during and after childbirth. Women who are sick visit their physicians more frequently than men with similar illnesses. Women are more likely to be injured due to domestic violence (1 in 5 Manitoban women have been victimized by their partner in the last five years). Women are more likely to be proactive with their health, seeking screening and taking preventative measures more often than men. Now here’s the scary bit: almost 1 in 5 women in Manitoba consulted a CAM practitioner in 2003 (the most recent data). Only 1 in 10 men did the same! These statistics are in reality even worse, as the analysis excluded chiropractic, which partially covered by the province and therefore “not alternative.” Women are more preoccupied with their health, more concerned with prevention, and therefore more likely to be taken in by quacks.

Here’s a figure from the report I’m getting my data from:

The higher the household income, the more likely the women would seek CAM (here denoted CAHC for "health care"). Men did not seek more care as it became financially feasible.

In other words, as women were able to afford it, likely due to both increased income and increased private insurance coverage with the better paying jobs, more women were using CAM. I certainly would be interested to see if the discrepancy is access in lower income brackets, or a lack of awareness.

Well, maybe, you helpfully offer, chronically ill women are more likely to use CAM, and the wealth changes represent their ability to try unproven treatments for their disease! Nay nay….

The majority of women using CAM are healthy!

So what now? We have a bunch of healthy, wealthy women who are out there spending money on homeopathy and reiki and healing meditation and detox regimens and spiritual communicators. Why is it our problem if women want to waste their money on unproven crap? Well, because it’s not right, and it’s not fair. We don’t teach girls to ask questions, we tell them to trust authority, we tell them that their problems aren’t important, we tell them that they’re not an important part of the skeptical community, and then we proceed to laugh at them for finding a sympathetic ear and falling prey to placebo effects!

Worst of all, thanks to “integrative” “medicine,” woo is pervading our hospitals. While walking through the Women’s Health Centre, I saw a poster for upcoming health workshops being hosted at the Centre that made me do a double take. Yes, sponsored by Alberta Health Services, you can take a $40, 2-hour workshop in Reiki (“massage for your soul!”), a $190, 12-hour class in Feng Shui, or a $48, 3-hour workshop entitled, I kid you not, “Talking to Your Angels and Learning How to Listen,” run by Sandy Day, who claims to be a Reiki Master, Shaman, and Intuitive Healer. This is not some backwoods hand-waving Natural Healing Centre Of Happiness and Puppy Dog Kisses, this is at the biggest teaching hospital in the city, the centre for the high-risk pregnancies, for breast cancer: the medical hub! Or, on Wednesday, September 17th from 7-9 pm, the classroom for “Energy Medicine – The Internal World.” Oh but don’t worry, in tiny text:

Women’s Health Resources does not support, endorse or recommend any method, treatment, product, remedial center, program or person. We do, however, endeavour to inform because we believe in the right to have access to available information in order to make informed individual choices.

Now, call me skeptical, but I’m pretty sure if I wander over to the Urology clinic, I somehow doubt that I will see the same advertisements promising healing touch lessons for prostate problems.

For more than one reason, really. (zpeckler@flikr)

If we don’t teach our girls to question, and if we don’t ask our women to think, stuff like this is only going to get worse. No amount of half-assed disclaimery is going to change the fact that misinforming anyone is the opposite of giving them an informed individual choice. Talking about the dangerous of being teleported to Neptune by devious extraterrestrial cows does not come into discussions of which car you’d like to buy. Yes, you should be aware of the pros and cons of every car, and yes you should be free to make that choice, but having some random loon come in off the street to convince people that our Bovine Neptunian Overlords only abduct people who drive Chevies is pretty much the opposite of informed consent, particularly if the random loon also happens to sell Toyotas. Why is the Women’s Health Centre not bringing in drug companies to give presentations on why everyone should be taking Lipitor? Perhaps because there is a major conflict of interest when you are essentially charging people to sit through a sales pitch? And this is actually a bad example, because at least Lipitor actually has demonstrable, independently reproducible benefits!

So yes, we do need more women in skepticism. We need women standing up for themselves, saying that they are tired of all this bullshit being thrown at them. Without female allies telling Oprah to go stuff herself and Dr. Oz to take his reiki elsewhere, the skepticism movement will never succeed at exposing fraud in CAM. Women’s voices don’t just deserve to be heard in skepticism, they need to be heard, for the sake of everyone’s health.

Ethical family planning, or, In which I ask a lot of rhetorical questions I can’t answer.

Being of a childbearing age in a committed relationship leads to a lot of pressing questions of a child-bearing nature. I, personally, don’t find the concept attractive for a myriad of reasons (pragmatic and emotional). The most frequent excuse I give to the well-meaning baby-loving types is my genetics – I come from a family history of early onset cancers of a few different varieties, auto-immune disease, and genetic high cholesterol, in addition to my own general feebleness and frailty. My significant other has a similar family history, with inflammatory bowel disease and diabetes thrown in there for extra fun. Neither of us are particularly healthy specimens of our species, and I’m quite content with removing myself from the gene pool of an already over populated planet.

I have always thought to myself that truly, passing on my sad, feeble, recessive genes could nearly be called child cruelty, given the nearly inevitable poor health any such offspring would have. We live in the age of genetics, of genome sequencing, of really cool new breakthroughs that can accurately identify genetic predispositions to everything from HIV susceptibility to autism spectrum disorders to that thing that some people can do where they fold their tongue up all funny.

Doing this is a dominant trait. I can't do this (or other tongue folds.) Damn you, recessive genes! (Photo from volver-avanzar on Flickr)

In any case, it’s gotten to the point where numerous companies have popped up to do private DNA testing to “screen” for specific genetics (the majority of which are useless for determining your health, like your blood type, and the ability to fold your tongue, both of which can be determined in a cheaper and much more practical way.) In any case, there certainly exists the distinct possibility that in the not-too-distant future, everyone will be screening for genetic susceptibilities to disease, because we all certainly have them, and certainly they can be important for making family planning decisions. If you and your partner are both carriers for a particular risk factor, 25% of your children will receive a double hit of that risk factor, or worse, have full-blown disease. Some might question whether that is something that we should know, but I think that’s a silly question to ask. Sticking your head in the sand because you’re afraid of the implications solves nothing. People are welcome to make their own decisions for their own health, but when you are talking about the theoretical health of your theoretical child, I don’t think ignorance is appropriate. If you and your partner are both carriers of infant Tay-Sachs disease, a progressive and painful genetic condition which results in children typically dying horribly by three years old, you should probably take that into consideration when thinking about having children. Having a severely disabled child that you know that you will outlive is not a burden that every couple is prepared to take on. But what about if your children will be at increased risk for breast cancer or stroke? At what point do you switch from having a “healthy” child to a “sick” child, especially when the majority of us have multiple genetic risk factors and carry potentially lethal but extremely rare genes that we are simply unaware of? And if we are all genetically “sick,” then hasn’t the word lost all meaning?

Would your fear of passing on the BRCA1 (Breast cancer 1) gene play into your desire to have children? And if it would, are you equally worried about the alleles that we don’t even know about yet? And if it wouldn’t, at what point would it become a factor? And how much of a guarantee do you need before it becomes a consideration? Does 25% worry you, or does it need to get to 50% or 75% before you give it a prominent spot in your mind? What about 100%?

Even more interesting is an experience I had today with an individual with a serious genetic disorder. His life is full of doctors’ appointments and treatments to keep him alive, and 100% of his children will be carriers, in addition to having milder symptoms themselves. Would you have a child if you knew that it would be sick? And perhaps more importantly, if you were sick yourself and unsure if you would be able to be around to help raise them?

I don’t know the answers to any of these questions – clearly, in a lot of situations, environment plays a large role, and that is something you can change to prevent issues. There is screening and increased vigilance for those genetically at risk. I think it is safe to say that carrying a risk factor for something that is by-and-large environmentally based, like cardiovascular disease, is something that wouldn’t prohibit most people from having a child. Being assured that all children would be miscarried or stillborn is probably something that would prohibit most people from having children, to save themselves the emotional trauma. There is a line between those, but where, and how much does it move between individuals, over time, over situations? And truly, how can you ever know what the right thing to do is without asking the person it will affect the most?

These are the sort of questions that run through my mind – feel free to answer them with your opinion and how you derived that answer. My feeling is that parents should be emotionally, physically and financially prepared to cope with a child with potential congenital abnormalities, but as long as they go into it with hearts and eyes open, who am I to interfere? And if they do not have the resources to care for a potentially ill child and so abstain from having children, who am I to look down my nose? I would say that it is morally undesirable to willfully have children with genetic problems is if that family is unable or unwilling to provide appropriate care and support for that child, much as you would say for any child, only accounting for the increased amount of care necessary. Apart from that, feel free to have kids when you like, with whomever you like, as many times as you would like.

Just, please, before you do: think of the children.