Posts by B Jones
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Oh, that's right, that was a man.
Yes, because it's the responsibility of the head of women's refuge to leap to the public defence of everyone violently killed, whether male or female. Perhaps she should also regularly speak out about the war in Iraq.
Both cases deserved comment and criticism from someone, but it's a bit much to snark about someone for focusing on the people they professionally represent.
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The numbers of terminations as a result of NTD diagnosis isn't well recorded here. The rest of the numbers are ok.
By cost/benefit, I mean the costs to bakers (and therefore consumers) of mandatory fortification over the cost of the ongoing support and healthcare of the NTD-affected children who, with fortification, would have been born without NTDs, or perhaps less serious ones. But damned if I can find the exact numbers now. The Paediatric Society alludes to them.
The sledgehammer/nut analogy implies a level of harm to fortification that nobody has been able to demonstrate. But yes, fortification is broad-brush rather than targeted.
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The Gay Oakes trial (also featuring Judith Ablett-Kerr) tried the domestic abuse = provocation defence, unsuccessfully. It's not what it was designed for, which is really a sudden outburst of righteous, violent rage where a person hardly knows their own strength. If someone has been repeatedly beaten by someone else, they're going to have to get creative to stand a chance against them, not just blow up only to get another hiding. And getting creative (poisoning, sneaking up on someone in their sleep) implies forethought, which negates provocation.
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Steve Barnes wrote:
we don't have "insanity" as a defence here but I think maybe we should. As it stands there is no way of "locking someone up and throwing away the key"
Yes we do. If someone doesn't know what they are doing, or doesn't know what they are doing is wrong, then they can be found not guilty by reason of insanity. From memory, and because I can't be bothered finding the right statute, someone so acquitted finds themselves an indefinite guest of our mental health facilities at the pleasure of the Minister of Health. I remember a trial a few years back that had the commentariat baying for a "guilty by reason of insanity" option for some particularly bad but insane killing. Maybe the guy who put someone's head in the dryer.
What we don't have is a diminished responsibility partial defence.
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Stewart - births and pregnancies are very different in this context. Numbers aren't very well recorded in NZ, but a significant proportion of pregnancies where NTDs are detected are terminated. I'm not sure why you expected fortification to be so effective - even vaccines aren't 100% effective, and NTDs aren't purely caused by low folate levels - there's a heredity component to them that means "at-risk" women are prescribed significantly higher levels than the general population. Fluoridation doesn't prevent all cavities, after all.
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I challenge anyone who considers their view to be broader than a "narrow clinical" one, to explain how anencephaly is anything other than a heartbreaking, pointless tragedy. NTDs go well beyond disability territory.
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There's more data in the links on the page I linked to, especially this one.
There are plenty of examples of things that were beyond the abilities of our forebears to avoid - rickets, goitre, smallpox etc, that we've been able to reduce in the last hundred years. It's a measure of the success of those efforts that we can take them completely for granted.
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Stewart: start here and keep reading, particularly the results of fortification in the US. In financial terms alone, the cost/benefit is pretty compelling.
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Amy - as I understand it, not having suffered from morning sickness myself, is that it doesn't necessarily show up first thing. The point of fortification is to make it as easy as possible to get your folate without realising it - coffee is even harder than bread, I'd say, because there is such a wide variety of forms people consume, and in widely variable doses. There's your instant, your big brand beans, your little independent roasters and your direct-from-Cuba importers - how do each of these groups comply with a standard?
I completely agree that it would be good to hear from people who actually suffer from spina bifida in this debate, but I can't see the issue of fortification as about judging their right to exist. That's a question every prospective parent who sees a neural tube defect on their 20 week ultrasound has to consider, sure. But the whole folate thing is about enabling people to exist without a serious disability. It's like preventing a car accident. That's spina bifida, anyway. Other NTDs include anencephaly, and it's a bit academic to talk about a right to exist with a condition you can't possibly survive more than a few hours with.
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You're meant to take folate supplements (not just eat healthily) between 1 month before conception to 3 months after. The hard part is taking supplements before something which you're not sure is going to happen. If you have no intention of becoming pregnant, it's impossible to plan for it, and you'd think that another sort of little pill would be further up the list to take if that's a risk. There's no way of knowing for sure whether you're pregnant or not until two weeks after conception, and this time is critical.
If you've got a reasonable (if not optimal) level of folate in your diet, things are less likely to go wrong for neural tube development (spina bifida, anencephaly). Given that most people, male or female, have suboptimal folate intakes, a little bit extra benefits everyone. It's just that the benefits are much more obvious for sub-12 week fetuses. The levels at which one study found a correlation with higher rates of cancer is maybe three times as high as what you'd expect to consume with fortified bread. If you're eating that much bread, you'll have other things to worry about.