Accidental Blogger

A general interest blog

  • Not so different from fighting poison with poison. Here.

    Cycle of fear

  • Va nurse
    Nurse – Anonymous

    Veterans Affairs Nurses Management Scrutinized After Patient Deaths in Two States (Norman Costa)

    A re-editing of an article by Tracy Weber and Charles Ornstein

    ProPublica, April 30, 2012, 1:19 p.m. 

    After a patient died last year at a Veterans Affairs hospital in Manhattan, federal inspectors discovered nurses in his unit [Management] had a startling gap in their skills [supervision and training of nursing staff]: They [Management] didn't understand [they were responsible for the competence and training of nursing staff as to] how the monitors tracking vital signs worked. 

    Shinseki
    Management – Gen. Eric Shinseki

    None of the nurses [management] interviewed could accurately explain [their lapse in supervision and training of nursing staff, so that nurses could tell] what would happen if a patient became disconnected from a cardiac monitor — which allegedly occurred to the patient who died, according to an October 2011 report from the U.S. Department of Veterans Affairs' inspector general. 

    The incident followed two deaths in the cardiac monitoring unit at a VA hospital in Denver that raised similar questions about nurse [Management] competency. 

    Earlier this month, a broader review by the VA inspector general of 29 VA facilities found only half had adequately documented that their nurses had the needed skills. Some nurses "did not demonstrate competency in one or more required skills," but there was no evidence of [Management taking charge and providing the] retraining [for nursing staff], the report said. 

    An outside nursing [management] expert who reviewed the reports at ProPublica's request called them "troubling" and said the fact that the [management] lapses weren't caught and corrected "signified much broader [management] problems." 

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  • Jonathan Haidt is a moral psychologist best known for his work on moral foundations, the basic dimensions along which peoples' moral intuitions vary. These include care/harm, fairness/cheating, liberty/oppression, loyalty/betrayal, authority/subversion, and sanctity/degradation. Interestingly, Haidt's research suggests that while conservatives bring all these dimensions to bear upon moral deliberation, liberals and libertarians use only the first three. His ''money'' plot shows how much people with different politics care about a given moral concern. Much of Haidt's new book, ''The Righteous Mind'' is devoted to explaining these dimensions and findings.

    Dimensions

    Haidt worries about acrimony between liberals and conservatives in contemporary America (his book is subtitled ''Why Good People Are Divided by Politics and Religion''), and thinks his work elucidates this disagreement. We simply have different moral "taste-buds", he says. It is not just disagreement he is interested in however, but moral incomprehension, failing to understand someone on the opposite side, or why he isn't a moral monster despite his views. Here he places more blame on the liberal side. One reason is that the overwhelmingly liberal academy and cultural elite participate in group-think and ignore insights from the other side. In his last chapter calling for political understanding, Haidt brings up people like Daniel Patrick Moynihan and Robert Putnam, also insisting on the value of market libertarianism and spontaneous order. He notes that science itself can suffer from political considerations, a star witness being the sociobiology wars of the 1970s. One can push back here – shall we stock Biology Departments with creationists, mightn't conservatives have ''differing interests'' as they suggest with gender representation, etc. Nevertheless, I do think he has a point, and won't pursue this argument further.

    Haidt's more interesting claim is that while conservatives deploy all the liberal moral criteria, liberals lack access to key conservative intuitions pertaining to loyalty, authority and sanctity. People from ''Western, Educated, Industrialized, Rich and Democratic'' backgrounds are disproportionately likely not to possess the full human moral palate. Hence, when asked to predict other peoples' moral responses, conservatives and moderates typically model liberals well. Liberals instead might be describing sweet-and-sour chicken while lacking sourness tastebuds. The left does often display cluelessness about rightwing motivations – consider only the post-2004 view that Americans were being 'duped' into voting for Bush, as if Kansans couldn't have non-economic, illiberal concerns of their own. Mind you, I suspect cultural Balkanization and homogeneity matter more here than any "palate" differences.

    Haidt also reviews evidence that the mind principally responds quickly and intuitively , not via rational deliberation. The image presented is of an elephant (intuition and emotion) and a rider (the consciously reasoning mind) where the elephant is largely in control. I do not have much to say here, and will direct the review to the rest of the book, focusing on a few points. First, the question of ''moral tastes'' and possible ways in which this model loads the die. I then suggest some fairly obvious political questions Haidt might address with his framework. Then I get to ''the evolution stuff.'' This is the bulk of my criticism, so I quickly summarize it by saying that I don't understand why Haidt needs a biological framework, much less a group selectional one, that his conclusions acquire only Science-y luster from it, and that he's just pretending to obtain this framework from biology anyway.

    A word on ''emotional'' matters: Haidt intends to challenge liberal complacency, so some liberal irritation is unavoidable. This is exacerbated by Haidt's unfortunate tendency to conflate psychological and philosophical claims where convenient. Much of the book implicitly suggests conservatives are ''right'', but backs away from direct argument (but note his opponents are everywhere called WEIRD!) Then at the end, Haidt switches open-faced to saying that his findings lead him to conclude conservatives are actually right, about happiness, community, welfare and diversity. I found myself shaking my head at the conversion narrative tone here.

    The usefulness of Haidt-the-evangelist to your thinking will likely depend on your openness to his conservative heroes. People who think conservatives are monsters with no brains and smaller hearts, will learn to think better by persevering through their heartburn. Those instead, who're sympathetically acquainted with some of his great heroes (Hume and Durkheim everywhere, some Burke, Hayek and Smith), might find his presentation uncritical, bordering on cheerleading. Doubtless this dichotomy is fraught; practically speaking, the first group has a predominantly third person existence! Anyway, while Haidt's biases are significant, he is valuable for liberals looking to scrutinize their moral presuppositions. In reading, one does well to watch out for the irritation, consciously deciding case-by-case whether to follow or swallow it. Contra Haidt, an ''emotional'' reading of the book probably will be inferior to a ''rational'' one! Despite my positive rating (I end up with 3.5/5), the following content frequently won't be. Whether this is valid counterpoint or residual irritation, I cannot say. But let's begin.

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  • by Omar Ali

    Pakistan is in the throes of an existential crisis. Pakistan has always been in the throes of an existential crisis. Pakistan’s interminable existential crisis is, in fact, getting to be a bore.  But while faraway peoples can indeed get away from this topic and on to something more interesting, Pakistanis have little choice in this matter; and it may be that neither do Indians.The-human-indian-spider

    The partition of British India was different things to different people, but we can all agree on some things: it was a confused mess, it was accompanied byremarkable violence and viciousness,  and it has led to endless trouble. ThePaknationalist narrative built on that foundation has Jihadized the Pakistani state, and defanging that myth is now the most critical historic task of the Pakistani bourgeoisie.

    Well, OK. We don’t actually all admit any of those things, but all those are things I have written in the past. Today I hope to shed my inhibitions and go further.

    First, the crisis. Some friends think I am being unnecessarily alarmist and the only crisis is the presence of American infidels/imperialists in the region. Let America leave and all will be well. Others believe that if the army had a “free hand”, they would have things under control within days.  Let us dispense with both theories. The crisis is not primarily American generated (though they have a long and glorious history of feeding dollars to the crisis) and no one is in complete control.  The existing corruption-ridden state is a British colonial creation struggling to get by alongside an unstable mix of Islamist ideology and a very shallow and self-contradictory foundational myth. Even though the karma of the Raj is potent stuff, it will not last forever against these forces. When it goes, the next step will not be the dawn of Chomskyan enlightened anarchy or democratic socialism; it will either be Salafist Islam or the dissolution of the state. Dissolution being physically and diplomatically difficult (who will handle the scramble over borders that would follow?), Salafist Islam administered by the army (perhaps with acharismatic cricketer as its public face) is the likely option.

    Unfortunately, it is not likely to work very well. In fact, it is incapable of sustaining even the bare minimum of modern statehood. Unlike Iranian Islam (which is literate, modern and sophisticated compared to Salafist fantasies) there is no there there.  A militarized salafist Pakistan may hold together a few years in the name of war against the infidels, but after the war (and who wants a war that could go nuclear?) we are left with little more than the vague notion of a rightly guided caliph, the whipping of uppity women and the accelerated cleansing of undesirable smaller sects. After all, if you have a religious state, then you cannot have ten different interpretations of religion (not to speak of ten different religions). Which vision is in charge has to be clear. The state must enforce religious uniformity or become secular. There is no third option.  One can see this principle in operation in Pakistan ever since General Zia started Islamizing in earnest.  Ahmedis were already beyond the pale,but Shias, a sect that provided the founder of Pakistan and were an integral part of Pakistan, now face the prospect of second class citizenship or worse. If you happen to believe in the Salafist project you may find this a desirable endpoint, but everyone else will want to stop this process and reverse it if possible.  

    To stop short of that particular landing, we have to repair what we have. What we have is very confused and the current “approved” mythology of Partition and an Islamic state serves to increase confusion and undermines what exists. That approved mythology therefore has to be set aside or defanged. This does not mean there are no other problems. There are tons of other problems, and many of them are bigger than salafist Islam in a worldwide context. But those problems are common to the whole region. They are common to the third world. They are even common to the rich countries. They are problems of power arrangements, of unbridled capitalism, of environmental degradation, of  individual alienation and so on. They are, in short, problems of where humankind is in the 21st century. There are many different approaches to these problems and many different solutions, precisely because we have not yet solved them. But there are other problems that were identified and solved centuries ago. For example, we moved on from the divine right of kings, the segregation of women, even the revolutionary vanguard and national socialism. The notion that we can have a religious state but somehow bypass the known problems of the religious state is not  tenable. But a salafist coup will be just that. The world has moved on, we will have to move on too.

    While this explains why Pakistanis need to worry, what about Indians? With enough problems of their own, why should they care two hoots about all this? I think they will have to care because there are clear limits to how far Indians can downgrade the importance of whatever craziness is going down in Pakistan.  IF we go down, we will take a lot of people down with us. India is not protected from the fallout by two oceans or even the high Himalayas. If Pakistan crashes down to Taliban level, India will have to scramble to avoid the fallout and given the realities of geography and the capabilities of the Indian state, that is not a job they can do very well.

    There is also a second reason why Indians should worry a little about what happens in Pakistan. India itself is a work in progress. Its integration of British India, modern democratic forms and the ancient but scientifically underdeveloped and culturally heterogeneous civilization of India is not a done deal.  It is easy for commentators to “discover” that India on the ground is not as different from Pakistan as Indians may wish it to be.  I am aware that there are differences and they are real; the stated ideal is superior, the historic basis is sounder, the religious landscape is too heterogeneous to even imagine monocultural purity, the dominant religion is Hinduism and so on; but the existing reality of everyday life is still very far from the ideal. While neither economic development nor democratic rule nor national integration are in imminent danger,  none of these are out of the woods. If Pakistan heads for salafist Islam, India will face not only terrorist attacks or overt hostility, it will find its own problems and weak spots revealed and exploited at a time when it needs to pretend it has moved beyond them in order to actually move beyond them.   

    The rational choice therefore is for India to help prevent such an outcome. And luckily, there is much that India can do in that direction.  Trade with India has the potential to transform the economy of Punjab and beyond. Transit to Afghanistan and central Asia will double that dividend. And travel and cultural exchange with India undermine the entire paknationalist narrative (which is why Hafiz Saeed and other Jihadist leaders have been launched to try and stop any such initiatives). While it would be a mistake to get carried away with the possibilities it would also be a mistake to miss opportunities just because the Indian-nationalist narrative emphasizes the differences.

    This sort of argument is very infuriating to some Indians (it also makes Paknationalists go ballistic, but I lost that constituency at paragraph two).  To be asked to help not because we are fellow human beings or long lost brothers (we already have that group of Indians lighting candles at Wagah border every year and I love them for it) but because if we really truly catch fire we could set the whole neighborhood aflame? It sounds almost like blackmail. “Internet Hindus” will obviously want no part of this, but even mainstream analysts can be skeptical; but dear think-tankers, think about it. Trade, travel and cultural exchange with India are the least expensive and most “high-return” means of saving Pakistan from a salafist catastrophe. Realpolitik, not sentimental humanism (I personally approved of sentimental humanism, but that is a separate matter) suggests that India actively take steps to prevent Pakistan from going down to the next level. Realpolitik also suggests that it is still possible. Pakistan is not the basket case it is sometimes projected to be; it is a fertile land with hardworking, enterprising people; a large economy with real possibilities of trade and investment; its ancient Indic cultures and shared Indic languages are still alive and provide a basis for deep interaction. India can open channels to help an alternative national myth to take root and survive in Pakistan even as it takes precautions to wall off harmful trends. Without some deft assistance (and precautionary walling off, the two contradictory trends will have to go together; it is crucial to know which approach is needed where) the “good” side is more likely to go down.

    The other big player is, of course, Uncle Sam. But that will have to be the topic of another article. Paknationalists had also set their hopes on Uncle Chin, but that may be wishful thinking

    more next time..Conjoined-twins

     

     

     

     

  • Just stumbled upon this marvelously loopy interview with the head of a Swiss Federal Ethics Committee. Said committee issued guidelines in 2008 pertaining to the dignity of plants. In Switzerland it is now permissible to harm plants, say for agriculture, but not to cause them arbitrary harm. An example of the latter: consider someone who casually decapitates some wildflowers on the road side.

    The issue has come about because Swiss lawmakers and citizens were worried about the potential dangers of genetic technologies, and passed a law requiring that the dignity of creatures be considered in research. Unfortunately, they seem not to have adequately considered that plants are quite creaturely in their own way. Hence guidelines about how you might respect plant dignity, in research and more broadly. Nature went to the trouble of writing an editorial – as you might expect, plant biologists in Switzerland are flummoxed.

  • Ap_trayvon_martin_jef_120329_wg
    Trayvon Martin

    Who Really Killed Trayvon Martin? (Norman Costa)

    This is a perplexing case.

    I learned a great deal about the justice system by attending a Moot Court. I put my second wife through law school, and I read some of her assigned material, and even attended some classes.

    I read the case book for the Moot Court trial. It was a rape case. The case book had lots of evidence for the guilt of the accused. The case book had lots of evidence for exoneration. Defense and prosecution worked from the same information. The role of opposing attorneys was to get as much of the evidence for their side into the trial, and keep as much of the opposing evidence out.

    This is not just an academic exercise. It is what many prosecutors are confronted with. They may feel that there is sufficient evidence to go to trial, though they understand that the defense will use evidence that could get the accused an acquittal. It is not necessarily true that they are absolutely sure "he done it." But they feel they have to go to trial and let the jury decide guilt or innocence.

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  • I Did Not Attend the Funeral, But I Sent a Nice Letter Saying I Approved of It
    Mark Twain

    If you gave him an enema you could bury him in a matchbox
    Christopher Hitchens ( about Jerry Falwell)

    Good! Fuck him. I couldn’t be happier that he’s dead.
    Matt Taibbi (about Andrew Breitbart)

    LOL, Fuck Muamba. He’s dead.
    Liam Stacey (Twittering about a footballer who had a heart attack [*])

    One of these men is going to prison. Lessons, for if you want to say something awful:

    • Try to be famous first
    • Eschew twitter in favor of traditional media like TV or print
    • The racial optics really matter
    • Stay as far away from Britain as possible

    [*] Update: the post above seems to have led to a back-and-forth on twitter where Stacey followed up his initial remarks with overtly racist and sexist remarks (sanitized transcript here) The post stands, but I wouldn’t want to say he was being roughly as offensive as Hitchens or Taibbi or Breitbart. Fellow seems to be closer to Westboro Church levels of iffiness.