Monday, April 28, 2008

Free Range Kids

Here's a promising blog by Lenore Skenazy, author of “Why I Let My 9-Year-Old Take The Subway Alone,” a controversial New York Sun article.

She raises an interesting point. I grew up doing all manner of nasty things, eating snow, playing in the dirt and the woods, etc. I think that's part of why I'm so healthy. And I did "dangerous" things sometimes too-- played in the street and the woods, went for walked by myself... At the same time, there are things that I think get progressively more dangerous each year. For example, my mom rode in a car without a seatbelt and was fine as a kid. However, at the time there were fewer cars on the road, fewer instances of drunk driving, and thus, fewer accidents.

The same is true of certain health concerns. I probably wouldn't want my kids to share toothbrushes or anything. That's not because I think there is anything inherently dangerous about sharing toothbrushes, and I did it sometimes as a kid. However, thanks to antibacterials, the germs today are a lot nastier than they were back then.

Cars are faster and drivers are stupider; I wouldn't want my kid crossing busy streets without me at least watching until I was VERY confident in their judgment. The same thing is true for letting them ride a subway or bike to school. I would want to be very confident that they knew what to do if something went wrong. As for snow and playing in the woods, eh, if the snow is new and I know where the kid is it's probably gonna be fine. It's a question of the world changing. More people close together means more danger. Nastier germs means more danger.

Would I bubble-wrap my kids? Hell no. Especially not as pertains to germs. If my kid eats food that fell on the floor, good for them for not wasting it. If they drink from the toilet, well, I might want to intervene. Washing hands after pooping, clearly a good idea. Drinking from the garden hose? My mom's rule was, don't put your mouth on the actual spout and you're fine.

It's about risk analysis. Fecal-oral transmission is a good way to get a whole mess of nasty illnesses, but the illnesses you get from the kitchen floor, not so much. Antibacterial sprays and soaps are good for daycares (lots of germy kids in one place) and bathrooms; elsewhere they are literally overkill. Helmets are a good idea for biking on hard pavement; they're not so needed for sledding on soft snow. I'm not too worried about abductions, but if my kid is out alone I'm gonna want to give them a cell phone in case they get lost or are out after dark. And yeah, there are a lot of things that were perfectly safe in 1950 that I wouldn't let a kid do today, simply because the world is not as safe. There are more people, thus, more dangers. Playing street hockey on a quiet cul-de-sac is not one of them.

Tuesday, April 22, 2008

And none of this means "natural" = "good"

I've been reading a lot of "natural mothering" sites lately, because crazy people amuse me.

Anyway, there's one thing that's been interesting me. The idea of "child-led weaning." Aka, you don't actively wean, you wait until your kid chooses not to breastfeed any more all on their own. Which usually means mothers nursing 4 and 5 year olds. It also leads to tandem breast feeding when new babies arrive (breast feeding your 5 year old, your 3 year old, and your newborn all at the same time).

Now, I don't see anything wrong with extended breast feeding per se, as long as the kid gets other foods, gains weight at a normal rate, and stops before they start school/daycare/major social interactions with peers who think it's weird so as to prevent social issues. And as long as the mother isn't pressuring the kid to breastfeed, either, which some moms seem to do. And I also don't think a mom should wean to formula, unless of course she has to for some reason. Breast milk's always best until the kid can drink cow's milk, if a mom can nurse sufficiently, formula's pretty much useless.

At the same time, what I object to is the idea that child-led weaning is "natural" mothering. Or "natural" at all. Because let's face it. Mammals wean their young. They do. Actively. At least humans don't kick their babies in the face to wean them, like grazing animals do. Natural mothering involves active weaning when the mom decides it's time to end it. If the kid self-weans before the mom was ready, great! But natural weaning means the mom stops the kid if the kid doesn't stop themselves fast enough to suit them.

What's more, tandem nursing? NOT natural. Not at ALL. I mean, obviously tandem nursing occurs for multiple births, and occasionally for animals-- or humans-- who nurse the offspring of a dead mother. But this idea of continuing to nurse the older child while pregnant and then while nursing a newborn? That's not "natural." Animals don't DO that. Humans in hunter-gatherer societies don't do that. IN fact, as far as I can tell, the only people who do that are modern hippie types.

In nature, animals wean #1 pretty much as soon as they can tell that they are pregnant (aka when they've got , so that they will have the energy and food supply for #2. The first child, at that point, is usually developed enough to survive on normal food. Meanwhile the second child needs all the colostrum and breast milk (and energy) the mother can devote to it. To tandem nurse would create a dangerous situation for the mother and more importantly, the new baby.

Now, obviously first-world humans don't have to worry about limited food supply or predators attacking a child. And honestly, if someone wants to tandem nurse, whatever, it probably won't hurt them. But it's not "natural" parenting. It's about as unnatural as it gets. Just saying.

Thursday, April 17, 2008

Abortions for some, miniature American flags for others...

A Yale student told the press that she intentionally impregnated herself and aborted the fetuses for an art project.

This of course sparked much outrage, until she revealed it was a hoax. She's a performance artist, and the point was to get a rise out of people. It also sparked much debate, because everyone tended to agree that the idea was sick and wrong, and yet, many of them also supported reproductive rights.

My reaction, before I learned it was a hoax, was not quite the same as some-- I was concerned that she was mentally ill and should be detained in much the same way that a person is detained for attempting suicide, because she was taking dangerous herbal abortifacients without a doctor's supervision. Also, I was appalled that any school would allow the display of an "art" exhibit involving dead human tissue, which is a blatant violation of health codes. So yeah, naturally, I thought she should have been stopped, evaluated by a psychiatrist, and the display destroyed.

But at the same time, most people were claiming that it was unethical, yet declaring they were pro-choice. This confused me, because they clearly thought she was killing something that should not be killed, and yet, they had no problem if it was done for other reasons. Doing it for art was atrocious; doing it for personal reasons acceptable.

It would be atrocious because it would be disgusting and a violation of health codes, and because she would have been purposely hurting herself in the name of her "art." That's obvious. But let's pretend that she was doing it for some other, more acceptable reason, like she was a scientist who wanted test subjects and couldn't get them from a abortion clinic, or something. And then pretend that she wasn't endangering herself, and ignore that aspect. Let's focus primarily on the other argument brought up: that it was immoral.

If you think a blastocyst is a human being, of course you would consider this immoral. You should then think all blastocysts are human beings, and regardless of circumstances think abortions are immoral (or by the same token, IVF clinics disposing of blastocysts that are not needed are also immoral). I do not agree with this, but I can respect this view because it is consistent (of course, if you're one of those who thinks it's only okay when YOU do it, all respect disappears).

And the reverse, if you think it is NOT a human being, you should then consider this strange and disgusting, but not strictly immoral because she's simply expelling tissue she does not need, even if she then has a strange purpose for it. That was my general impression. Now, I don't think it would be the same if she had pretended to abort a 6-month-old fetus, but she was talking about blastocysts, which are basically a bunch of stem cells. I know when I personally think life begins, and I am a firm believer that barring a danger to the mother's life when there is a choice between saving the fetus or protecting the mother, after that point the mother should continue the pregnancy and chose adoption if she is unable to care for the child. For me, that point's somewhere when the fetus has brain activity and could theoretically survive a premature birth.

But many arguing it was immoral are pro-choice, or partially pro-choice (ie rape/incest abortions are okay). The truth is, I have trouble understanding that veiw. Either it's a person at the given stage of development and killing it is immoral, or it is not a person and killing it is not immoral. It's not more of a person because it was intentionally conceived for the purposes of aborting it. It's not less of a person because it's father was a rapist or also it's grandfather. Once a child is born, we don't make those distinctions; why do we make them regarding those in utero?

Of course, some people argue that it's a child, but it's okay to kill children before they are able to form attachments and shit. Like up until a few weeks after birth. I don't agree with that one either, but hey, if that's your moral belief, you are entitled to it. However, since it's fairly easy to adopt out newborns, I would find the idea strange and a bit disturbing that infanticide would be the first option barring serious deformities that cannot be repaired and would give the child a miserable, short life.

I just can't understand those who set standards based on situation. If a fetus is a human being, how is it immoral to kill them because you can't care for them but not immoral to kill them because you were raped? And at the same time, if it is NOT a human being, how is it immoral to create them with the intent of destroying them but not immoral to create them accidentally and then destroy them?

The mother's intent, some say. But by that token, if intentional creation and abortion is murder, accidental creation and abortion should be manslaughter. We punish people for that. You have to research and decide. Where do you, personally, beleive that life begins? At conception, when the genetic code is set? Implantation, when pregnancy begins? When the heart begins to beat? When they can survive outside the womb? But once we decide, we should stick to it, and consider all fetuses at the same age equal barring medical situations.

Also, to clarify, in terms of law, I think that the law should allow abortion until the fetus could survive a premature birth with reasonable interference levels (so no partial-birth or late term). After that, only for medical concerns, and always the mother's life and health should come first. Because of the variety of opinions on when life begins, before the fetus can be removed from the body and given away the law should butt out.

Monday, April 14, 2008

Alternative Medicine and the Great Pharmaceutical Conspiracy

I am, in my heart, a skeptic.

That is to say, I don't tend to form opinions about things before researching them, and I can recognize real research as opposed to the biased stuff.

However, I believe in the power of yoga, massage, and tai chi to improve health, because I understand that such things are relaxing and good for the muscles, and relaxation improves health. I believe herbal remedies often work very well, because honestly, almost every medication we have today was derived from some form of plant or animal product that someone, somewhere, probably used to heal patients. Of course, they're way more useful, potent, and free of toxins in the refined form. I think DOs are a perfectly acceptable alternative to MDs and I would go to a licensed chiropractor for joint and back pain that did not respond to painkillers (though not for anything else).

So when I say I am a skeptic, I'm not the kind of person who thinks that all alternative therapies should be outlawed, or that any therapy that has not yet been tested in clinical trials must be completely useless. The truth is, clinical trials take time and money. Pharmaceutical companies can ensure that they have the safest and most effective product by charging high rates for their medications and trying those medications out on anyone who will volunteer or accept payment for it. It's usually many many years after the invention of a product that doctors even start hearing about it, much less the general public (the exception being new drugs that might cure some horrible and incurable disease, like cancer or AIDs, which the media loves even though it seems like 80% of them turn out to be dead ends).

Meanwhile, "alternative" medicine's inventors and promoters usually have certain traits in common: First of all, they are not affiliated with a licensed pharmaceutical company, usually because they either have decided Big Pharma is evil (a common problem in our society), because they do not have the credentials required to work for such a company, because any pharmaceutical company will look at their idea and say it's not worth the investment because it's so unlikely to work compared to the cost involved to develop it, or, and this is rare, because the pharmaceutical companies do not want the product to be made as it will not make them any money.

For example, medical marijuana? Pharmaceutical companies are just NOW starting to investigate it as a serious pain reliever, and they will never market it unless it is completely refined and processed because they're hardly going to make money if they announce that we can grow an effective painkiller in our backyards with absolutely no need for them. They are a business. Does that make them evil? No. They're still gonna look into it, and maybe whatever they come up with will be safer and more effective than smoking pot and it will be great. But they're a business. And if they weren't a business, where would the enormous amount of money required to research, develop, and test new medications come from? I don't know about you, but I sure as hell would prefer a business in charge of making sure my pain pills work so well that I keep buying from them and not their competitor than the government to be in charge of churning out the cheapest possible medication to shut me up while they lower taxes.

Anyway, back to the subject at hand. Alternative medicine. If a practitioner has decided that Big Pharma is evil, they have shot themselves in the foot, because there are three places that a practitioner can get the money and resources to turn an alternative therapy into a mainstream makes-lots-of-money one: Pharmaceutical companies, universities with a bunch of bored grad students, and the government. Strike out the biggest one-- pharmaceutical companies-- and you can have your research done by the lowest-bidder government or the universities, who have to apply for grants which most often come from-- you guessed it-- the government, or private industry like a pharmaceutical company. As it is, universities do a lot of testing on alternative medicine, but they can't do it in the same organized, methodical way that a pharmaceutical company with a lot of money riding on it can.

Now let's assume that they didn't go into it hating pharmaceutical companies, and instead applied to them and were turned down due to lack of credentials or the compnay thinking it was a poor investment. If they have insufficient credentials, then they should either go back to school and get the needed credentials and see if they still think that chelation will treat autism, or find someone who does have the credentials who is similarly interested. Chances are if they don't have the credentials and can't get them, or get someone with them to take an interest in their work, their work is based on that dream they had last week and not on actual rational thought, and you shouldn't be using it.

But what if they have the credentials, but the pharmaceutical company simply decided not to invest in whatever they are supporting? Well, that doesn't mean that Big Pharma is out to get them. They're gonna spend the same money on clinical trials and effectiveness studies if they are researching a new cancer wonderdrug as if they are trying to determine if Kombucha tea does anything to the body except look gross. They're gonna look through what evidence there is to support the idea, what evidence there is against it, and then yeah, they're gonna pick the investments that appear to be most likely to be worth the cost. And they pick wrong a lot (that's partially why meds are so pricey), but they're more likely to pick wrong if the wrong is supported by previous scientific study than if it's something the promoter pulled out of his ass. Plus, they have to market it to the mainstream, so even if you assume things like vibrational energy are real and most people are simply deluded, if most people will read vibrational energy on their pain pills and think "Uh, yeah, no thanks, that's ridiculous," a company would be stupid to invest in it.

Then, the final choice, the company doesn't want to do it because it's not gonna make them any money. PHARMACEUTICAL COMPANIES ARE NOT CHARITIES. Come on. They have to get their money back somehow, and clinical trials and R&D are expensive. I don't understand why people assume that doctors, lawyers, pharmaceutical companies etc should exist purely to help them, and not ask for anything in return. Honestly, even if the company WAS a non-profit, as many hospitals are, they can't LOSE money. Money does not magically appear because people are sick or in need, unless you're a politician.

The truth is, there are many alternative therapies out there that probably do work well enough that they would pass all the tests and be a worthwhile investment, but they don't appear it on the surface, or maybe they work but the cost outweighs the benefits compared to just taking the current medication, or maybe they work but not as well as (or as safely as) something we already have, or maybe they work but they sound silly and no one would ever buy them. It's a shame, but it's life. Hopefully those alternative therapies can be tested at universities enough to have a legitimate scientific backing to their claims, and maybe they will then be accepted by the more mainstream industries.

However, those alternative therapies are drowned out by the extremes, the coffee enemas, the chelation for autism, the psychic surgery, the fluoridation conspiracy theories-- the ones that quite clearly have no possible validity to them according to anyone who understands science, anatomy, chemistry, biology and in some cases physics. And that's why the potentially good therapies aren't investigated as they should be or accepted by the mainstream. It's not Big Pharma that's causing them strife, it's the fact that they are being lumped in for whatever reason with every other ridiculous and impossible quack therapy that anyone ever made a million dollars off. So alternative therapy practitioners-- stop blaming Big Pharma. Start blaming the snake oil salesmen.

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However, at the same time, I don't think that alternative therapies should be restricted unless they are actually dangerous. I think they should have to be tested and approved by the FDA according to the same standards as whatever they claim to be. If they claim to be a medicine or remedy, they should be held to the same safety standards as medicine, and require a prescription or not accordingly. If they are dietary supplements, they should also be tested (the US is atrocious in this regard, we need to have stricter guidelines about labeling and contents of supplements-- I'm sick of guessing if a brand of fish oil tablets will work or not). If it's a food, it should have nutritional information.

And if it's toxic, it should be treated as any other toxic substance. Alternative medications, whether they work or not, can be quite dangerous. At least most mainstream medications contain compounds that are safe in low quantities but will cause you to vomit if you overdose-- you're hardly gonna get that with herbal "supplements." Before alternative therapy can be held anywhere near the standards of conventional medicine it needs to hold itself to the same standards of safety.

Oh, and because I read a story about this on the internet: If your child has an ear infection, GIVE THEM THE AMOXICILLIN, don't wait until their eardrum perforates! Good god, it's an antibiotic, not rat poison. At least, if you must try alternative methods, check in their ear first and don't drop your homeopathic ear drops in through the perforation for several days until the kid is puking and screaming nonstop due to the fact you dumped WATER into their MIDDLE EAR. Good lord, that was horrific to read about.