Monday, August 31, 2009

How many reputable ‘who's who' registries are there operating in the USA?

How many reputable ‘who's who' registries are there operating in the USA? One or two: Marquis and A&C Black?
Over the past several weeks, I’ve been e-mailed and phoned by yet another ‘who's who' registry seeking to include me among nearly a million other ‘high rollers’ – then to sell me the volume, along with a plaque.  I don’t think they really ‘hear’ me (in the sense of ‘hear with understanding’) that an ethical vegan does NOT want a leather-bound volume that includes those names in the registry.  Not I (if you didn't realize it, that question is merely rhetorical, with only a negative answer possible).

A Wikipedia article ‘Who's Who scam talks about this issue, but as someone included in Marquis’ Who’s Who, I puzzle how many reputable ‘who's who' registries are there operating in the USA?

A Who's Who scam is a fraudulent Who's Who biographical directory.[1]  While there are many legitimate Who's Who directories, some individuals have created Who's Who scams that involve the selling of "memberships" in Who's Who directories that are created online and through instant publishing services.[1]  These are essentially thinly veiled scams designed to get individuals to part with their money.
Often the companies that "own" these registries are recently incorporated and the few individuals listed in them are people who are having themselves listed as a marketing tactic.  That makes the publication in these directories a simple form of vanity publishing, with the listed persons often posting their listing on their own web sites.
Online blogs or forum posts that discuss these scams often have posts from people stating they have used the directory to make valuable business contacts.  However, these posts cannot be verified and are much like other online reviews that provide no verification of the consumer's or user's identity.
See also
References
  1. ^ a b What Price Fame? Be a Very Important Person - all it takes is money, David Vernon, The Skeptic, 2007, Vol. 27, No. 2, p. 16
External links
  • What with the Who's Who? Who would be so foolish as to pay for inclusion in a Who's Who book that no one reads?  CSO Online
  • Vanity Publishing, guide against fraud by Connecticut State Attorney General
  • Vanity Publishing, consumer protection fact sheet list by Wiscosin Department of Agriculture, Trade and Consumer Protection
  • Who's Who Scam, on Everything2
  • Who Are You? Why Are You Here?, a New York Times review on Marquis 2005, called it an "authoritative tool and valid portrait of [American] society".
    By WILLIAM L. HAMILTON
    Published: November 13, 2005
    Photos: TONY HAWK -- Professional skateboarder. (Photo by Streeter Lecka/Getty Images); JOEL OSTEEN -- Televangelist. (Photo by Jessica Kourkounis/Associated Press);
    KANYE WEST -- Producer, rapper. (Photo by Steve Grayson/WireImage.com);
    KEN JENNINGS -- ''Jeopardy'' champion. (Photo by Associated Press);
    EVA LONGORIA -- ''Desperate Housewife.'' (Photo by Kevin Winter/Getty Images);
    (Photo by Tony Cenicola/The New York Times)(pg. 1);
    I'M IN THE BOOK -- In the 60th anniversary Who's Who in America, George W. Bush weighs in with one and a quarter column inches of biographical information. The Olsen twins, right (Mary-Kate, left, and Ashley), garner twice that much space. (Photo by Chris Jackson/Getty Images);
    (Photo by Peter Kramer/Getty Images);
    (Photo by Tony Cenicola/The New York Times);
    JUDGE AND JURY -- From left, Gene M. McGovern, Fred Marks, Kerry Morrison and Jon Gelberg of Marquis Who's Who in New Providence, N.J. (Photo by Marko Georgiev for The New York Times)(pg. 6)
THE 60th edition of Who's Who in America, that venerable guide to American achievement, was published last week. The familiar two-volume ''big red book,'' a librarian's Vanity Fair, recognizes 109,000 people and, by their inclusion, recommends them to posterity and to America's collective memory. Kind of like a magazine cover that stays on the stands forever.
But in the era of the Internet and Google, of reality television, gangsta rap stars, celebrity publicists, incarcerated domestic divas and the famous 15 minutes of fame (probably closer to 5 now), who is who?
''I think about this every day,'' said Jon Gelberg, managing director for special projects at Marquis Who's Who, the book's publisher. He was speaking at the company's offices in New Providence, N.J., where an editorial team of 70, including 12 researchers, make the call on who's notable and who's not. Talking about his work, Mr. Gelberg sometimes looked as stoical as Hercules.
Who's Who, traditionally a polite old-boys' club of state supreme court justices, clergymen, explorer/authors, botany professors and other conservatively distinguished academic, government, and professional figures, is now -- under a two-year-old management team that wants to recognize popular culture just as emphatically -- Who's In and Who's Out as well. The crowd squeezed into the latest edition is as much V.I.P. room as reference room. Think of going down in history as the ultimate afterparty.
Who's newly who for 2006? Kanye West, the hip-hop artist; Joel Osteen, the televangelist; Eva Longoria, the actress who plays Gabrielle Solis in ''Desperate Housewives''; Ken Jennings, who holds the record for the longest winning streak on the game show ''Jeopardy''; and Tony Hawk, the skateboarder. They take their places in American culture's carved stone with presidents, Nobel Prize winners, the entertainment elite and the titans of industry. Back after a one-year hiatus is Martha Stewart, whose stint in jail disqualified her in 2005.
Who isn't who yet? Alice Waters, the mother of new American cuisine. Who was who but isn't for 2006? Beck. Who isn't who, as in ''Who?'' Rod Strickland, the basketball player, and Linda Evans, a star of ''Dynasty,'' the popular 1980's evening soap opera.
And who will never be who? Victoria Gotti, the author, television personality and daughter of John Gotti. She is ineligible because of the Gotti family's associations with organized crime, what Marquis's editors term ''notorious'' or ''infamous'' achievement.
''My life is going to go on without it, believe me,'' Ms. Gotti said of a Who's Who citation, speaking by telephone from California.
Monica Lewinsky? Never had a chance.
But with the often upside-down nature of who is celebrated today, or why, occupational categories like organized crime are under review. Socialites, with a few exceptions, like the late, ubiquitous Nan Kempner, are kept out. Paris Hilton, the celebutante, was included last year, distinguished, Mr. Gelberg said, by her achievements in three industries: fashion, film and television.
''Popular culture has expanded and grown coarser, so there's no reason not to include Paris Hilton,'' said Matthew Boylan, a reference librarian at the Donnell Library Center of the New York Public Library. And librarians, to judge from several spoken to, are an egalitarian but tough crew when it comes to reference materials, exhibiting a protective ferocity that might impress the Gottis.
''Are we trying to make it more relevant? Absolutely,'' Mr. Gelberg said. ''Who are people talking about? Who is on magazine covers? People in the hip-hop world, X-Games types. We're adding them in greater numbers. This is a part of culture.''
Hard calls, like activists, are subject to debate. Cindy Sheehan, opposing the war in Iraq, is a Who by sheer volume of news coverage in the last year; Randall Terry, the anti-abortionist, is not, largely through oversight and not lack of newsworthiness, Mr. Gelberg said. Mr. Terry is being discussed for inclusion in 2007.
Part of the company's three-year plan to make Who's Who more relevant is to reflect the leadership among African-, Asian- and Hispanic-Americans. Brigida Benitez, a lawyer and president of the Hispanic Bar Association of the District of Columbia, is one example. The guide is also applying a brisk sweep of the broom to names that have gathered dust, not laurels. For 2006, 37,000 names were dropped while 20,000 were added. Marquis Who's Who also maintains a database, available by subscription, of 1.2 million names, including those in the book, those dropped, those being considered and those of the deceased.
For those included, it is a brutal world of column inches: George W. Bush, one and a quarter; Ashley and Mary-Kate Olsen, two and a half between them; Stephen Hawking and Cher, one and three-quarters each; Madonna, two; Noam Chomsky, six.
Though entertainers and other well-publicized figures are not new to Who's Who, which first appeared in 1898, its acceptance of popular culture has evolved. Professional athletes, who were considered laborers, were excluded until 1927, when Bill Tilden, the tennis star and social celebrity, was admitted. When Mae West was denied entrance to the big red book, she told reporters that its editors would not be included in her little black book. In the 1968-'69 edition of Who's Who, John Lennon is present but Mick Jagger is not, reflecting parental attitudes toward the Beatles and the Rolling Stones more than professional objectivity.
If Who's Who in America has created, by mosaic, a portrait of America and its tectonic shifts, its latest edition, with its new recognition of popular culture, is a picture that some might find startling to see -- like an unintended look in the mirror. Who's Who is a dry reminder that celebrity for celebrity's sake is now a seasoned American industry as powerful and internationally recognized as steel once was, driven by CD's, movies, fragrances, tabloid romances and the weightless gravitas of pure appearance.
''Hilary Duff, Britney Spears, Christina Aguilera -- they have enormous staying power,'' said Kerry Morrison, Marquis's managing research editor. ''Compared with Debbie Gibson?'' Ouch. Ms. Gibson, whom Ms. Morrison characterized as a ''flash in the pan'' -- Who's Who's worst egg-on-the-face nightmare -- was never in the book or the database.
At greatest issue at Marquis is whether Who's Who in America itself is still ''Who.'' With the information highway now an international Interstate, is a 5,919-page, $749 reference book an authoritative tool and valid portrait of society, or a dinosaur from the print age?
''It had a great name, but the product needed great improvement,'' said James A. Finkelstein, who with Wilbur L. Ross Jr. bought Marquis Who's Who in 2003. Appearing every other year until 1992, it is now an annual publication. People will fall in and out of the print edition more quickly than they have in the past, to make it more reflexive as a reference work, Mr. Finkelstein said. The company publishes 16 Who's Who titles, including volumes devoted to American women and to those in education, which are purchased primarily by libraries. A total of 25,000 copies have been sold for shipment for 2006.
How does a who become a Who? There are 73 categories and 800 occupations that constitute guidelines for admission, said Fred Marks, senior managing director. To shake out nominees, his staff reviews lists like the Forbes Celebrity 100 and the Fortune 500, as well as lists specific to various industries and professions. Researchers also compile names from general interest magazines like Time and special interest magazines like The American Lawyer, looking for new candidates or verifying that people included in the last edition are still Who.
''The fundamental standards here are position and accomplishment,'' said Gene M. McGovern, Marquis's chief executive. ''The book fills up fast -- Pulitzers, the Fortune 1,000, Congress.''
Ms. Morrison added, ''With an Oscar, you could stay in until you're dead.''
In 2006, 26 percent of those included are women, up from 14 percent 10 years ago.
Those selected are sketched biographically, then contacted for additional information or asked to fill out a form. Finished entries are not uniformly fact-checked.
''How far do they go to verify the information?'' asked Susan Newson, head of reference at the East Meadow Public Library on Long Island. ''That's the question. You have to assume those selected will not fudge the information or aggrandize themselves, because the list is fairly distinguished.''
Speaking for librarians, Ms. Newson added, ''We're a little suspicious, but on lesser-known people, we have nothing else.'' Robert Homer Simpson, for example, the first meteorologist to fly over a hurricane, in 1947, can still be found in Who's Who.
For many of those whose fame is in full bloom, like the hip-hop star Missy Elliott, being included in the book is not just another piece of publicity. She entered the book last year. ''I'm more than happy to be in company with Oprah and Hillary Clinton,'' she said on Thursday in a telephone interview. ''Looking at those accomplishments, it makes mine look very small. It makes you sit back.''
Ms. Elliott added: ''Reporters always ask me, 'What are the highlights of my career?' This would definitely be a first.''
This writing is fun reading and will give you a quick look at the issue, though it might not be trhorough or com,prehensive.  But in this world in which accomplishment takes time, who has time to be included.  What’s fame?  It’s independent of anyone’s recognition of the fame.

Thursday, April 26, 2007

Victoria Strauss -- Beware Who's Who Schemes

I've been planning on doing this post for some time, but putting it off because it involved a lot of research. What tipped me over the line? The other day my husband, Rob, got a solicitation from Cambridge Who's Who.

"It is my pleasure," the letter from Editor in Chief Jennifer A. Gonzalez begins, "to inform you that you are being considered for inclusion into [sic] the 2007/2008 Cambridge Who's Who Among Executives and Professionals "Honors Edition" of the Registry." This is a major honor, Jen explains, because the Registry will include biographies of "our country's most accomplished professionals," many of whom regard inclusion as "the single highest mark of achievement." There's an application form that Rob can fill out and send back if he's the snail mail type, or if he's electronically inclined he can apply online. Just in case it occurs to him to wonder whether there's a catch, Jen hastens to reassure him: "There is no cost to be included in the Registry."

Rob lives with me (and Writer Beware), so the first words out of his mouth were "This is a scam, right?" Unfortunately, many people are much less suspicious.

There are legitimate Who's Who publishers--A & C Black in the UK, Marquis in the USA. They research the people they include, and while they'd love it if you bought the book, that's not the main reason for their existence. Cambridge and its ilk, on the other hand, are all about the hard sell. Similar to the vanity poetry anthologizers, Who's Who schemes lure customers by presenting themselves as a no-cost opportunity, but make their money by persuading people to buy books and/or memberships--often at costs exceeding $1,000. They claim to be selective, but in reality they harvest names just as junk mailers or spammers do, randomly and without regard to credentials--which means that their networking value, often touted to justify the enormous membership or purchase fee, is negligible. The bigger ones attempt to tailor their solicitations--Rob is in insurance, so he got the Executives and Professionals letter. A woman might get an invitation to the Executive and Professional Women registry. There's a solicitation for people in education. There's one for scientists. There's one for healthcare professionals. Here's an especially disgusting one targeted to people with religious affiliations.

The Who's Who gambit is a long-running, recognized telephone sales scheme about which there are a number of official warnings. There's a dizzying number of different Whos--many of which, I would guess, are run by the same people, though they're pretty good at making themselves seem separate. Here are just a few examples:

- United Who's Who (which has an unsatisfactory record with the Florida BBB for failing to respond to complaints)
- International Who's Who Historical Society (ditto)
- American Who's Who Association, which has a number of different schemes
- Premier Who's Who (formerly Prestige Who's Who, also d/b/a America's Who's Who)
- Emerald Who's Who
- Madison Who's Who (this one also has an unsatisfactory BBB record)
- Global Register's Who's Who (formerly National Register's Who's Who).

Frequently, the Whos are short-lived. Doctors' Who's Who and Nationwide Who's Who are now only Internet memories, but Google either of them and, as with the rest, you'll see people who list them as a professional credential. Ditto for Enterprise Who's Who--which suggests one reason for the schemes' short shelf life in the legacy of complaints it has left behind.

Back to Cambridge Who's Who. It's half of a two-headed hydra made up of Cambridge Who's Who (which previously did business as Manchester Who's Who and Empire Who's Who--according to a press release on Cambridge's website, these two have "merged" to become Cambridge) and Metropolitan Who's Who. Cambridge and Metropolitan do business separately, and have different websites, URL registry information, and mailing addresses. But their logo designs and their solicitation letters are identical (compare Manchester-now-Cambridge's letter with Metropolitan's)--as are their hard-sell telephone tactics.

People who answer the solicitations from Cambridge and Metropolitan report very similar experiences. (These links represent a fraction of the online discussions and complaints about Cambridge in particular.) A representative of the company phones them, congratulates them on the honor of their inclusion in the registry database, and conducts a lengthy interview, with many questions about careers, professional accomplishments, etc. Once the victim has been softened up by this process, the phone solicitor lowers the boom. The victim--who, remember, is under the impression from the initial solicitation letter that no costs are involved--is told that there are two levels of membership--a cheaper junior membership (currently close to $800) and a more expensive lifetime membership (currently nearly $1,000). This money, the victim is assured, isn't for inclusion in the database; it's for access to the database--which surely they're going to want to have, since the registry is a fantastic networking opportunity. To sweeten the deal, there are extras--gift certificates, airline ticket vouchers, a handsome award certificate, a media kit. If the victim expresses doubt about the cost, the solicitor says something like "You know what? Because I really don't want you to miss out on this fabulous opportunity, I'm going to offer you a lower rate! You'll only have to pay what a charity organization pays!" More hard sell tactics ensue. If the victim continues to resist, the solicitor hangs up on him or her--just like those magazine-sales scams where the people rudely blow you off the instant they realize you aren't going to fall for their line of bullshit.

I'm sure it won't surprise anyone to learn that Cambridge and one of its predecessors, Empire, have poor records with the Better Business Bureau (Manchester has no separate record). Empire's BBB report shows 57 complaints over the past 36 months, most involving (surprise, surprise) selling and refund practices. Cambridge's BBB report shows a stunning 150 complaints over the past 36 months, again involving selling and refund practices, and also billing and credit disputes. The bulk of the complaints--123 out of 150--have been made in the past 12 months.

Metropolitan's BBB report is currently being updated. When I viewed it in February (when I first began thinking about doing this post), it cited complaint patterns similar to Cambridge's. Some of the content of that report is reproduced by blogger T.J. at his dogscatskidslife blog.

Another thing Cambridge and Metropolitan share: a very poor reaction to criticism. The hydra really, really doesn't like it when people say bad things about it. When the Southern Conservative blog featured a satirical post about a solicitation letter from Metropolitan Who's Who, a threat of legal action quickly followed from one Cyndi Jeffers of Metropolitan (she also contacted people at the blogger's job). Blogger Shawn Olsen, whose description of his experience with Manchester Who's Who is linked in above, is being pursued by a lawyer hired by Manchester/Cambridge, who threatens a defamation lawsuit and demands $7 million in compensatory and punitive damages. These two bloggers appear not to be the only ones who've experienced this kind of harassment.

So here's my long-distance gift to all of you: a little dose of the good ol' Writer Beware suspicion that Rob has absorbed by proximity. "Money flows to the writer" is a good maxim to live by--but in cases of unexpected invitations, so is what Groucho Marx said: "I don't want to belong to any club that will accept me as a member." If you hear from a Who--and don't assume it will be one of those I've highlighted in this post, because I wouldn't be surprised if Cambridge, at least, were thinking it might be time for a name change--don't hesitate. Toss the letter straight into the recycling bin. That is, unless you want to make fun of it on your blog.

  • Who's Who Scam and Vanity

Men with hypertension may effectively reduce that hypertension with whole grains and bran

Whole grains, bran may fight hypertension in men
U. S. News & World Report as reported by HealthDay News, August 28, 2009 – By Steven Reinberg
Harvard researchers that found that whole grain foods and foods high in bran bring a boost to heart health. Although the study focused on men, data from the Women's Health Study is consistent with the results. Lead researcher Dr. Alan J. Flint, Harvard School of Public Health research scientist and project director of the Health Professionals Follow-up Study, comments.
http://health.usnews.com/articles/health/healthday/2009/08/28/whole-grains-bran-may-fight-hypertension-in-men.html

HealthDay

Whole Grains, Bran May Fight Hypertension in Men

New findings replicate similar data for women, experts say

Posted August 28, 2009
By Steven Reinberg
HealthDay Reporter
FRIDAY, Aug. 28 (HealthDay News) -- Men, want to keep high blood pressure at bay? Try reaching for whole grains.
That's the message from a Harvard study that found that whole grain foods and foods high in bran bring a boost to heart health. Although this study is among men, data from the Women's Health Study found similar results, the researchers say.

"Whole grains as a part of a prudent, balanced diet may help promote cardiovascular health," said lead researcher Dr. Alan J. Flint, project director at Harvard School of Public Health of the Health Professionals Follow-Up Study, on which the new analysis was based. "Higher intake of whole grains was associated with a lower risk of hypertension in our cohort of over 31,000 men," Flint said.
The report is published in the September issue of the American Journal of Clinical Nutrition.
For the study, Flint's team collected data on 31,684 men who participated in the Health Professionals Follow-Up Study. When these men were enrolled in the study, none had high blood pressure, cancer, heart disease or had had a stroke.
During 18 years of follow-up, over 9,200 men developed high blood pressure. The researchers found that men who ate the highest amount of whole grains were 19 percent less likely to develop high blood pressure compared with men who ate the least amount of whole grains.
In addition, men who ate the most bran reduced their risk of developing high blood pressure by 15 percent compared with men who ate the least bran, the study found.
Flint noted that these findings remained even after adjusting their data for other healthy lifestyle and diet factors. "When the associations persist despite these adjustments, as in the current analysis, it supports the conclusion that it is not due to these other factors," he said.
There have been several suggestions as to why whole grains seem to have an effect on blood pressure. These include improved insulin sensitivity, reduced food intake, lower blood sugar, better control of high blood pressure and less need for blood pressure medications, the researchers noted.
The authors say the findings could help in evaluating diet guidelines to help lower blood pressure.
Connecticut-based nutritionist Samantha Heller agreed that whole grains are an important part of a healthy diet.
"Whole grains have nutrients and antioxidants that are important for good health and they help manage insulin response," Heller said. "People who eat whole grains seem to have lower incidents of diseases like diabetes," she said.
Since whole grains also help manage weight, they seem to reduce the risk of heart disease, she said.
However, Dr. Harlan M. Krumholz, the Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health at Yale University School of Medicine doesn't think this finding has any implications for dietary guidelines.
"This epidemiologic study is an interesting academic study but lacks any policy implications," Krumholz said. "We do not know whether enriching your diet with fiber will have any benefit on the development of hypertension," he said.
More information
For more information on a healthy diet, visit the U.S. Department of Agriculture .

Quite a gift of candor to global health and human rights

China Admits to Organ Harvesting

Published August 29, 2009 @ 08:04PM PT

(photo credit: Daquelle manera)

The China Daily, a government-controlled Chinese newspaper, admitted Wednesday that organ donation in the country was heavily dependent on executed prisoners. This is the first government admission of the link between executions and organ donations.

They made the admission in an article published on August 26 that focused on China's new Red Cross-run national organ donation system. It stated that "China launched a national organ donation system yesterday in a bid to gradually shake off its long-time dependence on executed prisoners as a major source of organs for transplants and as part of efforts to crack down on organ trafficking."

I am stunned. This was the stuff of shady rumors and hand-letters signs carried by crackpots. I can't believe that the Chinese government is really admitting this, and I can't believe there hasn't been more outcry from the global community. It's a very canny move by the government of China, I guess. Deny everything until you have a system in place to fix things. Then what can anyone do? You're already trying to fix it. As an added bonus, if the Chinese population doesn't start singing up for voluntary organization donation, then the government can blame the people when they go back to using prisoner donations.

The article does not address some of the darker claims made about Chinese organ harvesting. The worst I have heard is that the Chinese governments advertises to "organ tourists" about clean-living Falun Gong prisoners, and then executes condemned prisoners once their organs are sold. This also leads to an implication that the government of China has an incentive to arrest, condemn, and execute constant flow of prisoners.  (And if you think that sounds paranoid, think how crazy the organ harvesting sounded until the government of China admitted it was true.)

I don't think those darker fears are irrational. If a Chinese government mouthpiece is admitting that "Some just ignore legal procedures regarding organ donations from executed prisoners and make a fat profit," and "organ middlemen have been faking documents in order to make a person who is desperately in need of money be considered ‘emotionally connected' to the recipients," you have to wonder what they're not saying.

Quite a gift of candor to global health and human rights

China Admits to Organ Harvesting

Published August 29, 2009 @ 08:04PM PT

(photo credit: Daquelle manera)

The China Daily, a government-controlled Chinese newspaper, admitted Wednesday that organ donation in the country was heavily dependent on executed prisoners. This is the first government admission of the link between executions and organ donations.


They made the admission in an article published on August 26 that focused on China's new Red Cross-run national organ donation system. It stated that "China launched a national organ donation system yesterday in a bid to gradually shake off its long-time dependence on executed prisoners as a major source of organs for transplants and as part of efforts to crack down on organ trafficking."


I am stunned. This was the stuff of shady rumors and hand-letters signs carried by crackpots. I can't believe that the Chinese government is really admitting this, and I can't believe there hasn't been more outcry from the global community. It's a very canny move by the government of China, I guess. Deny everything until you have a system in place to fix things. Then what can anyone do? You're already trying to fix it. As an added bonus, if the Chinese population doesn't start singing up for voluntary organization donation, then the government can blame the people when they go back to using prisoner donations.


The article does not address some of the darker claims made about Chinese organ harvesting. The worst I have heard is that the Chinese governments advertises to "organ tourists" about clean-living Falun Gong prisoners, and then executes condemned prisoners once their organs are sold. This also leads to an implication that the government of China has an incentive to arrest, condemn, and execute constant flow of prisoners.  (And if you think that sounds paranoid, think how crazy the organ harvesting sounded until the government of China admitted it was true.)


I don't think those darker fears are irrational. If a Chinese government mouthpiece is admitting that "Some just ignore legal procedures regarding organ donations from executed prisoners and make a fat profit," and "organ middlemen have been faking documents in order to make a person who is desperately in need of money be considered ‘emotionally connected' to the recipients," you have to wonder what they're not saying.

Believing Untruths - The Dangerous Lack of Critical Thinking


Monday, August 31, 2009

Believing Untruths - The Dangerous Lack of Critical Thinking

Sharon Begley has written an important essay in Newsweek, “Lies of Mass Destruction,” that every educator should read. Begley explores the strange, but ubiquitous, tendency of people to believe untruths even when there is massive evidence to contradict them. Whether it’s the persistent belief among many that Saddam Hussein was responsible for the 9/11 attacks, or the current beliefs about “death panels” (among other misinformation) in the pending health care reform proposals, we humans consistently believe things that simply are not true.

At the risk of raising the ire of my readers who believe in many unsupported things (and I’m not naming any of these for fear of inciting that ire), I can only say that Begley has just touched the tip of the iceberg. We believe in countless unfounded, unproven, even preposterous ideas and religious dogmas (not to mention what might make for good scifi or fairy tales), and many of us don’t even flinch when we present these unfounded beliefs as truth and seek to proselytize.

One of my favorite bumper stickers reads: “Don’t let your mind be so open your brain falls out.” I worry that between the poles of open-mindedness and close-mindedness (often resulting in the same sorts of beliefs in untruths), there lies a vast arena that we are failing to cultivate: critical thinking.

Critical thinking was a hot button subject in the 90s, and every school was eager to ensure it was teaching this skill. Now it’s been relegated by many “back to basics” proponents as soft, liberal, untestable and far less important that passing those standardized tests.

But it is dangerous to neglect critical thinking. An inability to access information critically, especially in an Internet age of massive information and misinformation, leads to an inability to participate honestly and realistically in a democracy.

In the 20th century, a few dystopian novels, such as Brave New World and 1984, exposed the danger of mass thought. Ironically, there are plenty of people who believe silly things who consider themselves disciples of such books, whether on the left or the right. They may believe in unfounded conspiracies or false information, perceiving themselves as the true critical thinkers and the rest of us as duped.

The only solution I see to this pervasive tendency among people is to commit fully and wholeheartedly to cultivating critical thinking and inculcating healthy skepticism among youth. Yes, it means they may question their parents beliefs. Yes, it means they may question their teachers. Yes, it means they may question entrenched institutions and systems. It also means they may question peer pressure, advertisers’ unhealthy manipulations, and the health value of their cafeteria food (I just had to throw that in).

If we teach the next generation to be deep and hard-working thinkers, we will give them perhaps the most important skill people need to create healthy, productive, fair and just societies and systems.

~ Zoe Weil

Image courtesy of rossgram via Creative Commons.

Sunday, August 30, 2009

Animal byproducts in common medicines and over-the-counter preparations

Why doctors should inform their patients where the medicines comes from

My many readers will know - from my many blogs (one Yahoo! 360 blog, recently closed by Yahoo! - had 1.3 million readers) that (a) I am NOT A FAN OF NOMINAL RELIGIOUS IDENTIFICATION - (b) nor am I supportive of arbitrary defections of any kind to lower moral standards.

An infrequently recurring question on vegetarian medical discussion lists in including those on topical medical concerns, where some clinicians and medical trained professionals are signed up, is animal ingredients in common medications. Some great servants of the vegetarians community like the Michaels - Dr. Michael Greger and Dr. Michael Klaper, have tried to help us steer clear of common over-the-counter preparations with animal ingredients, as have some pro-animal organizations (not only PETA, but others, too). You'll noted that, to the discredit of both vegetarians and presumptive vegetarians who are clinicians who ought to know the products AND our ethical and moral scruples about animal byproducts, many clinicians - including nominal Hindus, nominal Jains, nominal Adventists, and others - have failed to engage in pro-active HELP and service to the vegetarian communities, though they MAY be uniquely qualified to do so. Is it laziness or a misshapen sense that their NEW 'higher calling' is professional loyalty, a a jingoistic chauvinism to their professional colleagues, even when the profession is doing the wrong thing.


Let's get one thing clear: NO product of ANY kind should have ANY kind of animal ingredient or byproduct in it.

Therefore, no MEDICAL product of ANY kind should have ANY kind of animal ingredient or byproduct in it.

There's wide-ranging ignorance of this moral truth, but medical and health professionals who are NOT ignorant have even less to say in their defense when they err than have those whose moral laziness merely REFLECTS the social backgrounds from which they come.


In a column in the New York Times this week, Randy Cohen fields a question from an anaesthetist.

Should the doctor ask a devoutly religious patient whether he minds that his anticoagulant (heparin) is derived from pigs?

In his reply, Randy Cohen suggests that the doctrine of informed consent requires the doctor to consider the non-medical preferences of the patient and to make sure Muslims, Jews, and vegetarians (like us) know where medicine to be used in their treatment is coming from.

That's a second best (or third best, or not good) standard at best, but that's what Randy Cohen offers. It's a standard that's been around, has been widely accepted by medical ethicists and others in our culture, and seems to work with little additional thought. After all, clinicians should have a laboratory 'sense of things' that would include routinely understanding the chemical nature of stuffs, stuffs used in clinical treatment.

Are you with us so far? Good!

So Randy Cohen, in his New York Times article a week or so ago, suggests that the doctor's role includes a duty to provide whatever information patients need in order to make decisions about, decide, and effectively manage or control their care. But some doubt that it is a doctor's responsibilityto take into account what they call "preferences" (because they don't clearly understand the moral status of animals d they dismissive discount or deny their personhood.

These deniers claim that the doctors' role is too greatly extended.

:

"Imagine a vegan who takes particular exception to drugs that have been tested in higher order primates. Is the doctor expected to ask about all possible preferences and provide corresponding advice about treatments that conform to these? If so, this seems to be unreasonably demanding."

Briton Wikinson goes on to distinguish what he terms "the normative force of different claims about information-giving" (in other words, different nuances have different moral claims and intellectual legitimacy):

"There is a difference between

1. what would be good for the doctor to do, and
2. what we should expect the doctor to do, and
3. what we should sanction the doctor if they don't do?

If your doctor knows that you are a devout religious adherent, and that you may have an objection to a medical product that they know contains animal products, the doctor should inform you that the drug she is about to prescribe is derived from pigs. It would be good for them do so (level 1 above)."

So far, so good.

"And if you ask your doctor - does this drug contain animal products then the doctor should (stronger - probably level 2, maybe 3) find out about the drug and let you know."

Here's where we can take issue:

"Whether we should expect them (2) if you haven't asked or sanction them (3) if they didn't tell you is less clear to me.

We might also note that there is another side to responsibility when it comes to personal preferences for different treatments. If your preference is idiosyncratic or unusual you, the patient, probably have a responsibility to find out which potential treatments may contain animal products, as well as to let your doctor know that you really don't want animal products (or blood products etc). On the other hand if the preference is very common within the population perhaps the onus should be on the doctor."

Finally, Wilkinson quibbles further:

"As for the relevance of all of this for orthodox judaism, Randy Cohen notes that since Heparin is administered subcutaneously rather than orally it is apparently not proscribed."

Thinking here of being carried away kicking and screaming while refusing ill-intentioned treatment, I rephrase German Lutheran Pastor Martin Niemoller just a little:

First they came for the Muslims, but I wasn't a Muslim...

Then they came for the Orthodox Jews, but I wasn't an Orthodox Jew...

Then they can for the ethical vegans, and I wasn't an ethical vegan...

Then they came for me, kicking and screaming (and what did they want to do surreptitiously to MY body, about which I would object?)...

Let's put it this way:

Ethicists, particularly bioethicists should be thankful (or, if they don't believe in thankfulness, count themselves fortunate) to HAVE observant Muslims, Orthodox Jews, careful SDAs, self-caring body-owning feminists, and us ethical vegans BECAUSE we help to clarify the case that humans DO object to anyone's surreptitiously sneaking objectionable methods into their treatment and materials and substances into our bodies - in the same way we object to the USDA's approval of GMOs, irradiation, chemicalized agriculture, and more.

We should be THANKFUL that the woman's movement in the West and around the world has joined this chorus of these serious moral objections, and we should WELCOME American Republicanswho are yelling at the top of their lungs:

"Just one moment! What's going to be IN this treatment? What's going to be IN this health care program?"

We psychophysical unities of every stripe, brand, variety, background, persuasion, and pattern of human dignity demand no less than a transparent and open discussion of all these issues, even if it means that some well-intentioned measures can't be ramrodding into law quite so quickly.

Those who KNOW there is objection should be especially eager to fund research into NON-objectionable methods of caring for and preserving human health and for restoring it when illness and disease emerge (and for reducing and eliminating pain and providing proper care and treatment when that's the limit of suitable medical intervention).

We all know that the status quo in healthcare is not good enough, but it's more than access to currently-available treatments and their funding that's a mess. What is also all messed up is the WAY our society thinks about health and healthcare. I can give Ted Kennedy credit for noting that we ought to be paying doctors for keeping patients well, but I only puzzle whether or not we have trained these physicians to KEEP people well (when so much emphasis is placed on listening to complaints and treating post-diagnosisconditions.

Why not listyen to us? Of coruse, they ARE listening to us, and if it flies and flies far, they can claim it as their own.

And who should we be to com,plain if they DO develop treatment modalities that are agree of animal exploitation and abuse, focus first on primary prevention, emphasize a strong role for individual responsibility for health andsocial support for enabling that personal responsibility (safe and suitable exercise facilities in all workplace regions and residential areas, designing urban and suburban areas for exercise, and eliminating all subsidies for animal agriculture and making fresh produce afforcable and safe; shifting emphasis from high tech medicine to wards the low-hanging fruit of primary prevention, etc.). After all, what does it mean sociologically to be a servant of the greater public good, the good of all society? It means to serve wisely and effectively; it does NOT mean taking the credit. In the long run, the HEALTH of the people is FAR MORE IMPORTANT than the healthcare delivery of the people UNLESS that healthcare delivery PREVENTS the problems in the first place.

It is BETTER to have NOT suffered at all than to have suffered ravaging illness and disease, then, after costly treatment funded socially, to have recuperated (at least temporarily). Treatment costs money directly AND in lost productivity AND in lost happiness AND in suffering AND in grief for significant others and workplace colleagues. Being HEALTHY IS a savings. That's "IN THE NATURE OF THINGS" for all of us.

If you're looking for healthcare delivery savings, it's in keeping people well; that's why we're shifting to the IDEA of paying healthcare providers differently: paying healthcare systems (not just the doctors) for keeping people well.

In the search for cost savings, Peter Orszag should be exploring primary prevention. Shouldn't we all?

But don't put those animal ingredients in MY treatment protocols (and if we're well, we're less at risk for the medical violation of our bodies).

And the lowest common denominator, and thus the cheapest path for pharmaceutical companies, is to make ALL medicaments FREE of all animal ingredients and byproducts.

The ethicist (note point 3 above) told us that those who object the most should object the loudest because they're the ones who are hardest for the dulled mainstream to hear. We need to make OUR cases that we want an ethical and above-board system of providing health services to our species that don't violate the inherent rights of persons - nonhuman AND human.

And it's better to proactively make the case early than to resort to attorneys 'post-diagnosis' (after our bodies - and bodily rights - have been violated).

Saturday, August 29, 2009

Panis Angelicus

Panis angelicus is the penultimate strophe of the hymn Sacris solemniis written by Saint Thomas Aquinas for the Feast of Corpus Christi as part of a complete liturgy of the Feast including prayers for the Mass and the Liturgy of the Hours.

The strophe of Sacris solemniis that begins with the words "Panis angelicus" (bread of angels) has often been set to music separately from the rest of the hymn. Most famously, in 1872 César Franck set this strophe for tenor, organ, harp, cello, and double bass; later arranging it for tenor, chorus, and orchestra, he incorporated it into his Messe solennelle Opus 12. The 1932 performance of that work by John McCormack in Dublin's Phoenix Park became the highlight of his career. Noteworthy renditions have also been performed by tenors Luciano Pavarotti, Plácido Domingo, Richard Crooks, Donald Braswell and Roberto Alagna, as well as by the sopranos Magda Olivero, Renata Scotto, and Chloë Agnew. Singing trio The Priests give an extraordinary rendition in their debut album.

The phenomenon whereby the strophe of Sacris solemniis that begins with the words "Panis angelicus" is often treated as a separate hymn has occurred also with other hymns that Thomas Aquinas wrote for Corpus Christi: Verbum supernum prodiens (the last two strophes begin with "O salutaris Hostia") and Pange lingua gloriosi (the last two strophes begin with "Tantum ergo", in which case the word ergo ["therefore"] makes evident that this part is the continuation of a longer hymn).

Text of Panis angelicus, with doxology

Latin text An English translation
Panis angelicus
fit panis hominum;
Dat panis caelicus
figuris terminum:
O res mirabilis!
Manducat Dominum.
Pauper, servus et humilis.


Te trina Deitas
unaque poscimus:
Sic nos tu visita,
sicut te colimus;
Per tuas semitas
duc nos quo tendimus,
Ad lucem quam inhabitas.
Amen.
The angelic bread
becomes the bread of men;
The heavenly bread
ends all prefigurations:
What wonder!
consumes the Lord
a poor and humble servant.


Triune God,
We beg of You,
that you visit us,
as we worship You.
By your ways,
lead us who seek
the light in which You dwell.
Amen.

The article Sacris Solemniis in the Catholic Encyclopedia discusses the merits of a number of different translations.

Friday, August 28, 2009

LOVE CHANGES EVERYTHING

Love, love changes everything
Hands and faces, earth and sky
Love, love changes everything
How you live and how you die
Love, can make the summer fly
Or a night seem like a lifetime
Yes love, love changes everything
Now I tremble at your name
Nothing in the world will ever be the same

Love, love changes everything
Days are longer, words mean more
Love, love changes everything
Pain is deeper than before
Love will turn your world around
And that world will last forever
Yes love, love changes everything
Brings you glory, brings you shame
Nothing in the world will ever be the same

Off into the world we go
Planning futures, shaping years
Love (comes in) and suddenly all our wisdom disappears
Love makes fools of everyone
All the rules we made are broken
Yes love, love changes everyone
Live or perish in its flame
Love will never never let you be the same
Love will never never let you be the same

Wednesday, August 26, 2009

Health reform: throwing good money after the bad
The Huffington Post, August 24, 2009 – By Marcia Angell
Dr. Marcia Angell, Harvard Medical School senior lecturer on social medicine and former editor-in-chief of the New England Journal of Medicine, discusses her views on how healthcare reform should be approached.
http://www.huffingtonpost.com/marcia-angell-md/health-reform-throwing-go_b_266596.html

Marcia Angell, M.D.

Marcia Angell, M.D.

Posted: August 24, 2009 08:49 AM

Health Reform: Throwing Good Money After the Bad

It's not just the right-wing crazies who oppose health reform. In addition, there are many sane Americans who worry about committing a trillion dollars to it. They have a point. We already spend more than twice as much per person on health care as other advanced countries, and our costs are rising faster. How much is enough?

Make no mistake, sky-high and rapidly rising costs are the core problem. If money were no object, it would be easy to provide full care for everyone. But even a perfectly designed system will fail if it is unaffordable, or rapidly becomes so.

So it's crucial to ask just why we are spending so much more than other countries. Where is all that money going? Yet, that question is seldom asked in the current debate, even though it's not logical to try to fix something without understanding why it's broken.

In the trenchant words of Deep Throat, let's follow the money. This year we will spend roughly $2.5 trillion on health care. Although about half that money comes from federal and state governments, most of the total is funneled to private insurers and entrepreneurial providers. Alone among advanced countries, we treat health care like a market commodity to be distributed according to the ability to pay, not like a social service to be distributed according to medical need.

For nearly two-thirds of Americans, we rely on hundreds of private insurance companies to set prices and benefits and pay providers. They profit by refusing to cover the sickest patients and limiting services to others. In fact, we have the only health system in the world based on avoiding sick people. Insurers cream 15 to 25 percent off the top of the premium dollar for profits and overhead (mainly underwriting) before paying providers.

Providers themselves have high billing and collecting expenses to deal with the Byzantine requirements of multiple insurers. The innumerable health facilities, both for-profit and nonprofit, also have high overhead expenses to cover their business costs, executive salaries, and the promotion of their profitable services. Altogether, overhead accounts for at least 30 percent of our health bill. If we spent the same percentage on overhead as Canada, we would save about $400 billion this year.

Our method of delivering care is no better than our method of paying for it. We provide much of it in investor-owned health facilities that profit by providing too many services for the well-insured and too few for those who cannot pay. Most doctors are paid on a piecework basis -- that is, fee-for-service -- which gives them a similar incentive to provide too many services for the well-insured. That is particularly true of specialists who receive very high fees for expensive tests and procedures (like cardiac angiography and MRI's).

Not surprisingly, our ratio of specialists to primary care providers is much higher than in other countries. There is no way to know exactly how much money is wasted in medically unnecessary tests and procedures, but it is probably on the order of hundreds of billions of dollars per year. Many people point to technology as a cause of our high health costs, but the culprit is not technology per se (all advanced countries have the same technologies), but the flagrant overuse of it for financial gain.

In sum, the answer to the question, "Where is all that money going?" is that much of it is diverted to profits and overhead, and to exorbitantly priced and medically unnecessary tests and procedures. Any reform that has a prayer of containing costs, hence being sustainable, must deal with these two massive drains.
Yet, most reform proposals would leave the present profit-driven and inflationary system essentially unchanged, and simply pour more money into it.

That's what is happening in Massachusetts, where we have nearly universal health insurance, but costs are growing so rapidly that its long-term prospects are bleak unless we drastically cut benefits and greatly increase deductibles and co-payments, or change the system. We're learning that health insurance is not the same thing as health care; it may be too limited in what it covers or too expensive to actually use. It is ironic that the President is said to have looked to Massachusetts as a model for national reform, even though the state has the highest health costs on the planet.

To control costs, the President is pinning a lot on electronic records, disease management, preventive care, and comparative effectiveness studies. But while these initiatives may improve care, they're unlikely to save much money because they don't deal with the underlying problem -- a system based on maximizing income, not maximizing health. Promises by for-profit insurers and providers to mend their ways voluntarily are simply not credible. Regulation of the present system is also unlikely to modify profit-seeking behavior very much, without a bureaucracy so large that it would create more problems than it solves.

Nearly every other advanced country has a largely nonprofit national health system that guarantees universal care. Even countries with private insurers, like Switzerland and the Netherlands, require uniform prices and benefits and limit profits. Not only are expenditures much lower in other advanced countries, but health outcomes are generally better. Moreover, contrary to popular belief, they offer on average more basic services, not fewer -- more doctor visits and longer hospital stays, and they have more doctors and nurses and hospital beds. But they don't do nearly as many tests and procedures, because there is little financial incentive to do so.

It's true that there are waits for some elective procedures in some of these countries, such as the U. K. and Canada (although hardly the long lines of desperately ill patients depicted by the Republicans). But that's because they spend far less on health care than we do. If they were to put the same amount of money into their systems as we do into ours, there would be no waits. For them, the problem is not the system; it's the money. For us, it's not the money; it's the system. We already spend more than enough.

Judging by the current debate, it would seem that Americans think they have nothing to learn from other countries, or perhaps that we are all alone in the world. Still, we might be willing to learn from parts of our system that are similar to systems in other countries. Medicare is a single-payer program very much like the Canadian national health insurance system. (Some of the more vociferous town hall meeting protesters seemed not even to know that Medicare is a government program.) The Veterans Health System is a socialized program very much like the U.K.'s national health service. Both deliver better care at lower prices than our private system.

I believe our best bet now would be to extend Medicare gradually to the rest of the population. We could begin by lowering the eligibility age from 65 to 55, then after a few years, drop it to 45, and so on. Medicare is the most popular part of our health system; unlike private insurers, it offers free choice of doctors, it covers all eligible beneficiaries for a uniform package of benefits, regardless of medical history or how much care is needed, and it cannot be taken away by job loss or illness.

But it would need some changes. Its costs are rising almost as fast as those in the private sector, despite the fact that its overhead is much lower, because it uses the same profit-oriented providers. If Medicare were extended to everyone, it should be in a nonprofit delivery system. In addition, fees would have to be adjusted to reward primary care doctors more and specialists less, or better yet, doctors should be salaried. There is now a bill in Congress that calls for exactly that -- H.R. 676 ("Expanded and Improved Medicare for All"), which was introduced by Rep. John Conyers of Michigan and has many co-sponsors. Unfortunately, given the power of the health industry lobbies, it's unlikely to make it out of committee without strong public pressure.

In economic terms, health care is a highly successful industry -- profitable, growing, and virtually recession-proof -- but it's a massive burden on the rest of the economy. I'm aware that phasing out private insurers would mean a loss of jobs. But I believe the job loss in that sector would be more than offset by job gains in the rest of the economy, which would no longer be saddled with the exorbitant costs of an industry that offers very little of value to justify its existence.

One thing is certain: We need a complete overhaul of our health system. Tinkering at the edges won't do it. Expanding coverage through government subsidies and mandates, as advocated by the president, won't either. Besides being a windfall for insurers and drug companies, that approach will just add to our soaring costs and be a temporary fix, at best. In my opinion, it makes no sense to throw good money after bad.


Marcia Angell, M. D., is Senior Lecturer in the Department of Social Medicine at Harvard Medical School. She was the first woman to serve as Editor-in-Chief of the New England Journal of Medicine, a post she stepped down from in June of 2000. She is also the author of the critically acclaimed book, Science on Trial: The Clash of Medical Evidence and the Law in the Breast Implant Case, as well as The Truth About the Drug Companies: How They Deceive Us and What to Do About It.