Posts by dyan campbell
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Nope. I did it by assuming that gay athletes might be put off by the outwardly homophobic sports world.
You mean gay as in out and proud, not as in closeted, yes? Then you'd be right... clearly there would be some incentive to stay way at the back of the closet. But if you think rugby players, firemen, cowboys or even the Village People themselves don't have sex with men because they look so masculine, well, we just thought you were confused.
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My point about the numbers was that I don't consider the All Blacks to be selected from the general population and so the chances of a player being gay were much much less than most might expect.
Well, yes we see your point but we think you are extremely mistaken. However you arrived at associating effeminate behaviour with homosexuality and butch & homophobic behaviour with heterosexuality, you couldn't be more wrong in your assumption.
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I made the comparison because I know you're a deeply compassionate person, and have worked with HIV+ and AIDS people. You wouldn't go all fiscal on them, and I'm not sure it's the right thing to do to other young people who make shitty choices.
But however compassionate I may or may not be Russell, I am acutely aware of how tired people with small budgets and busy emergency rooms resent the growing abdication of personal responsibility for health and safety. And while I am sympathetic to the dumb kids who drink to the point of risking their lives, I don't see any problem with addressing them directly with the information that their decisions have costs. Fiscal costs, personal costs, physical costs. Actually I don't think alcohol advertising should be banned, but I do think we should bring the role of the liquor industry lobby into the discussion we have with young people.
Nowhere have I suggested medical care should be withheld, nor do I believe it. But I have a hard time equating someone who needs skin grafts because they jumped over a burning sofa with someone who has contracted a disease. And I am horrified to see how quickly this sort of drinking is rising around the world, but fascinated to see the scrambling response by health agencies internationally. They haven't got a lot of money but there is a huge, concerted international effort by health agencies to tackle the alcohol lobby head on.
It's interesting, and it is a version of what went down between tobacco industries and society in the 60s and 70s.
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Which is setting up something of a straw organ argument, because I'm not aware of any place where George Best wannabes are going to find themselves at the top of a transplant waiting list in this or any other life time.
I'm not quite sure what you mean by George Best Wannabes - but liver transplants are given to anyone who needs them - including alcoholics and addicts.
I have not participated in any bioethics or medical ethics committees here in NZ, but certainly in Canada and most developed countries, organs go to all physically suitable candidates.
There are ethical issues posed by the danger of relapse into alcoholism though, and there are limits as to how effective a transplant is going to be in someone who is gravely ill.
In the case of anyone who is not likely to survive with their new organ, they are not going to be given that organ.
The disease of alcoholism is very hard to overcome, even after hepatic failure and a transplant, which is why specific ethical guidelines must be met to qualify as a candidate for a donated organ. In other words, the alcoholic is assessed for how likely they will be able to give up alcohol (partly judged on how well they abstain in the months prior to their transplant) and partly on how messed up the rest of their health is.
From the following quote you will see the problem ethics committees have with alcoholics getting livers is not so much do they deserve them, but will they survive if they get them. If they are so sick they are not likely to survive or if they have been unable to stop drinking while waiting on a transplant list, then there is no other way to see a healthy liver transplanted into their bodies as anything but a waste of precious resources.
Liver Transplantation for Alcoholic Liver Disease
Alcohol affects many organ systems in addition to the liver. For example, as described alcohol abuse can lead to:
Damage of the heart muscles (i.e., cardiomyopathy) and skeletal muscles (i.e., skeletal myopathy).
Inflammation of the pancreas (i.e., pancreatitis).
Malnutrition.
Central and peripheral nervous system dysfunction.
“Soft” bones that lack minerals for stability (i.e., osteopenia/osteoporosis).
Cancers of the airways and digestive tract.
These conditions, particularly if they are severe, can complicate the management of patients with ALD (alcoholic liver disease) both before and after OLT (orthoptic liver transplantation) and some may even be contraindications for OLT (Keeffe 1997).
However, some of these alcohol–induced conditions (e.g., cardiomyopathy and acute pancreatitis) can be reversed by abstinence, and when such a reversal occurs, these conditions do not affect the decision on a patient’s suitability for a transplant.
This is in the USA I believe, but you will find comparable guidelines in most western countries. You'll note the fear of wasting a good liver is not so much a judgement of whether the candidate "deserves" it, but whether they will actually survive as a result of the transplant.
But even if you don't want to start dividing folks into the deserving and undeserving unwell, and rationing health care accordingly, plenty of people do.
This debate began not over the deserving and undeserving unwell, but over the well who make themselves unwell.
There are very few people in medical circles who would like to see medical care withheld from individuals who set fire to themselves because of something they saw on Jackass or who get so sick from recreational drinking they wind up in a medically induced coma, requiring incredibly expensive ICU care. But there are equally few who would see this as something that is not wasteful.
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Well, I'm sure the Fat Police don't think anyone in the dairy sector is honour-worthy due to their trafficing in obesity and death.
Well I don't know that raising cows and milking them quite rates an honour, but from a nutritional point of view most dairy products are just fine. Wonderful even.
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It's really far too early in the year to get my grumpy on, so I'd like to thank all you taxpayers out there for "squandering precious resources" on keeping this alkie nutter alive, and a productive and (more or less)functional contributor to the tax base.
Craig, I'm also very grateful you were kept alive (if only to keep me on my toes on PAS in both literary and sociological forums!) and in no way is this kind of treatment you describe "squandering precious resources".
I used the phrase "squandering precious resources" when referring to perfectly well young people who drink to the point of requiring medical attention without any concept that this might be wasteful or that their care is a frustrating and ultimately useless way to spend the time and money NZ allocates to health spending.
In the case of alcoholics who need liver transplants - while I do think they should certainly qualify for organ transplants - I am horrified to think how much longer the list of those waiting for organs is than those who will get them. And I am even more horrified to see that the demand has increased because of alcohol consumption more than any other thing.
But in the case of alcoholics who are given transplants, but are unable to stop drinking and progress on to further alcohol related disease and organ failure - yes, I think it would be squandering precious resources to give them a 2nd healthy donor liver.
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Dyan, I'm still waiting for a response to my crticism that you confounded binge drinking and alcoholism.
Sorry Emma, I did conflate binge drinkers with alcoholics in the quote of mine you selected, which you are right to correct.
Not all binge drinkers become alcoholics - but they are 500% more likely to become alcoholics.
The point I was trying to make was that every episode of binge drinking costs us in terms of health dollars, police resources.
In the case of alcohol induced liver disease now taking up 25% of all donor livers (this is UK data - but changes in demographics in drinking are global and being tracked with great interest by epidemiologists) this is a huge strain on limited resources than can't simply be bought with money.
Nowhere did I suggest addicts, alcoholics or HIV+ / AIDS patients should be denied medical assistance or organ transplants. (The exception where I do think medical assistance should be denied is to HIV+ and women with AIDS who want IVF treatment funded.)
Or my comment that people should comment with some compassion for the groups they're talking about and not be quite so judgy-pants.
Why is is a lack of compassion to say that people in society have a responsibility not to waste precious health resources and police time binge drinking?
And it boggles me why you can't see what Russell is saying. Your criticism about them (binge drinkers and/or alcoholics) taking livers away from Decent People can be applied to any health problem that is the result of something people have done voluntarily. Hence people who have contracted AIDS through risky sexual behaviours.
Someone who is HIV+ or has AIDS is already sick, so I don't see how their situation is comparable to someone who is in perfectly good health who drinks to the point that they require an ambulance, the attention of clinicians, often an ICU bed and the care of an ICU specialist - often they later need the attention of a gastroenterologist - not to mention the things the poor orderlies and janitors have to do. This is expensive and irresponsible.
I didn't say we should refuse these people medical care - and I do believe we should try to understand what motivates a big chunk of society to suddenly behave differently than that demographic did a generation earlier.
Danielle's introduction of the word "moral" was initially just to observe an emerging "moral panic" angle in the media, involving the huge jump in alcohol consumption by young women. And I answered that I did believe if we make a choice to behave irresponsibly in society and the consequences of that behaviour cost other members of society, then yes we can certainly frame those choices in a moral context.
Wouldn't there also be a 'moral responsibility' to not 'squander' health resources on people who indulge in unhealthy sexual, sporting or eating practices, or is it only people who indulge in unhealthy drinking practices you find "morally reprehensible"? I genuinely can't see the difference you can see.
Not all HIV/AIDS patients become infected because of reckless behaviour - though there is no moral judgement applied when they do. Rather there is a specific branch of psychiatric care that is extended to individuals (and yes, they exist) who deliberately infect themselves with HIV, and once HIV+ try to re-infect themselves with as many strains of HIV as possible. This isn't good, but no moral judgement is made of their behaviour - rather it points to a cluster of psychological problems that have to be treated along with the physical.
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Danielle, if by moral you mean a responsibility to other people in society not to squander precious resources on binge drinking, then yes, moral.
Woah, Dyan. Would you deliver the same sermon to, say, HIV victims? They cost heaps. Fact is, people don't always make good choices.
Russell, I'm still waiting on a reply to this. This is a pretty big leap, don't you think? How do we get from me saying individuals have a moral responsibility not to squander precious health resources on binge drinking to me sermonising to either HIV+ or AIDS patients who need medical assistance?
I'm still defending my position that it is morally reprehensible to waste precious resources - whether this means health budgets, very limited supplies of clean donor organs or police time and resources.
To sell the pastime of binge drinking to young people in general, and women in particular and try to make the very excesses and the expensive problems that ensue part of the identity of young people themselves is nothing short of insane. And it is increasingly a strain on an already stretched public health service.
@Steven -
Are you not talking about the higher rates of alcohol related male suicides, imprisonments and undiagnosed depression than women?
I was referring specifically to the cohort of alcoholics - and in that group, more women alcoholics have a mental illness than do alcoholic men.
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Fetal alcohol syndrome, is an unfortunate reality...
Yes, well, I would categorise FAS as damaging to society as a whole rather than to women.
When I said "alcohol is more damaging to women" I meant if a woman drinks the same amount of alcohol as a man - even if you adjust it proportionately to their respective sizes - women's bodies are damaged far more readily and far more extensively than are men's.
For example, alcoholic women develop cirrhosis of the liver faster than men, they develop alcohol–induced damage of the heart muscle (i.e., cardiomyopathy), and nerve damage (i.e., peripheral neuropathy) after fewer years of heavy drinking than do alcoholic men.
Female alcoholics have die at 100 % higher rate than male alcoholics do; female alcoholics are more likely to die from suicides, depression, alcohol-related accidents, circulatory disorders, and liver disease.
There is emerging evidence women's brains are more susceptible to damage from alcohol than men's - which may go a long way to explaining the huge disparity between the sexes in mental illness and suicide associated with alcohol dependance.
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And we don't seem to be unique in this.
Both the trends - increased binge drinking in young people in general and a very sharp increase in young women in particular - these are global, market driven, deliberately crafted and highly profitable trends.
We need to be aware how aggressively alcohol is being marketed to our young people and we cannot let the alcohol industry hijack the "rights for women" tag as the tobacco industry did a generation or two ago. This is criminal, and it is why it is offensive that someone like Doug Myers is recognised for "services to community".
This marketing trend targeting women is worldwide:
In the Nova Scotia Liquor Commission business plan 2009-10, women 45 years of age and younger who live in Halifax have been identified as a revenue-generating target group. It is important for these women to know that they are being targeted for alcohol marketing strategies, and be reminded of the risks associated with alcohol.
And the fallout - both in terms of physical harm and harm to society - is going to be enormous. This is blowing out health budgets and ruining the long term physical health of people.
Women More Susceptible to Damage from Alcohol than Men
The World Health Organisation has launched a worldwide campaign to try to do with alcohol what they did with tobacco a decade earlier, though how effective they are remains to be seen.