Sunday, 31 January 2010

Adopt a Cop

Evening all. Police Constable George Dixon here to report more rum doings at Dock Green. The Home Office has given the Christian Police Association(CPA) £10,000 to fight crime with the power of prayer.

The CoAct Adopt A Cop project will fund Christians and police working together in the community.

A CPA co-ordinator at each police station tells churches what needs praying about and CoAct have also issued a list of general guidelines that include praying for:
  • Neighbourhood police officers
  • Success in preventing and detecting crime
  • Catching offenders
  • Sick and injured officers
  • Officers to resist corruption and to be able to relax when they're off duty
  • Local streets or housing estates plagued by crime
  • A reduction in crime
A spokesman for the CPA said: 'There is circumstantial evidence to suggest that prayer might help reduce crime and community tension'.

Circumstantial evidence is not far removed from magical thinking aka post hoc ergo propter hoc reasoning, making a direct link between two unconnected events. For example, I wore my purple pants to a job interview and got the job therefore the purple pants helped me get the job and are henceforth lucky pants. Or, the police arrive at a crime scene to find a dead body with a woman kneeling by it holding a bloody knife and arrest her for murder on no other evidence. This is not the kind of policing we at Dock Green were trained to carry out. As an experienced bobby with many years on the beat, I certainly would not stand up before the beak with such 'evidence'.

The executive director of the CPA, Don Axcell, offers up his 'evidence': 'In one particular area, an officer was investigating an incident but he had not been able to apprehend a suspect. He encouraged a church to pray and within days a suspect had been arrested and charged. In another area, an officer encouraged churches to pray about domestic burglary and over the year it came down by 30 per cent.'

He does add ' We do not discount good police work, which is why we call it circumstantial evidence' but his meaning of 'circumstantial' appears different from everyone else's.

So which is it, prayer or good old fashioned coppering? The CPA are in no doubt. The CoAct website says: 'Pray for your police. Prayer is the key, powerful and changes things. It is the slender nerve which moves the hand of God and we are asking him to intervene in our community'. According to them, 'prayer undergirds action and forms part of an holistic Christian response to crime reduction'.

Ah, holistic policing. So much better than the regular sort. Undergirding is what a jock strap or Wonder Bra does.

Are the CPA aware that there is strong evidence (none of it circumstantial) that praying for sick people does not help them and, in fact, can make them worse and impair their recovery? If a church prays for a particular officer to catch a villain and he fails, whose fault is it? Did they not pray hard enough or was it part of His Mysterious Plan that the perp walked?

Why would God give special help only to those boys (and girls) in blue who were prayed for? Does He not care about the others? What happens at stations where there is no CPA member to set up the Prayer Force?

There has been no attempt to test this 'evidence'. No control group who are not prayed for or who do not know whether they're being prayed for or not. For good measure, they should perhaps also have a group of bobbies who have been cursed to see if they do significantly worse. Attributing a 30% fall in domestic burglaries to the power of prayer fails to take into account any other factor that might have caused the drop.

Encouraging local communities to support the police is no bad thing. But quite apart from the unscientific thinking going on here, there are other religious police groups who have not, so far, received any money. There are Muslim, Hindu, Sikh and even Pagan Police Associations. Perhaps they have no 'evidence' that their prayers reduce crime figures. Perhaps the Home Office has confused the Chief Constable with the Man in the Sky. Or perhaps God is in fact a supernatural coppers' nark.

Giving money just to the CPA is likely to create division between different sections of the Force. There seems to have been little or no thought about how this will make non-Christian officers at a police station feel when their colleagues are singled out for special treatment. Officers who have no belief at all are expected to work alongside those who think that supernatural power is helping them.

One officer said: 'It's like asking the Fairy Godmother to bring in all the criminals on the run'. The fact that he or she didn't want to be named does not bode well for this divisive and ill-conceived project. A project, let's not forget, which is funded by the tax payer.

Wednesday, 20 January 2010

Circumcision and HIV/AIDS 4

The king of the Zulus has issued an edict to bring back circumcision in KwaZulu-Natal, South Africa, two hundred years after it was abolished.

King Goodwill Zwelithini claims to be reintroducing the practice because it reduces HIV transmission but evidence for its effectiveness is contentious, as I have discussed here, here and here.

The Xhosa, South Africa's second largest tribe after the Zulus, never gave up traditional circumcision. Uncut men are considered inkwenkwe - boys - who are not allowed to mix with the men. Hospital circumcisions do not count.

Health workers tell of the serious problems it causes including 'rotting penises, septicaemia and inadvertent castrations'. Other boys die of dehydration or hypothermia and, far from preventing the spread of HIV, circumcision can increase it as the same knife is used on a large group of boys. In the last year, 80 boys have died, including two suicides.

Researchers into traditional circumcision found that ‘in general, communities considered morbidity and mortality as par for the course. Interviewers were told that "deaths and injury were seen as a way of separating out those boys who were not fit to play the role of men in society." Compounding this 'natural selection' technique, another popular belief is that if an initiate suffers medical complications, he has brought it upon himself through some form of wrong doing, and is therefore being punished'.

On top of the health risks, the rituals place a heavy financial burden on poor families who have to come up with goats, blankets, alcohol and new clothes for the boy.

There is often criticism of Zulu men by the Xhosa for not being circumcised. In 2008, ANC politician Fikile Mbalula (a Zulu) succumbed to pressure and, at the age of 37, entered an initiation school where he was circumcised the traditional way. He later became deputy minister of police. These two events may not be linked but they may also suggest why the Zulu king wants to bring back circumcision. Zulus make up 21% of the population and Xhosa 17%; the difference is small enough for the Xhosa to exert considerable influence.

As I wrote previously, the South African government recognizes the health risk. In 2001 it passed an act requiring a license from a medical officer for each male circumcision. The act seems to be having little effect.

Given that the Xhosa circumcise for purely cultural reasons and the ritual is what counts, it seems unlikely that the Zulus will accept hospital circumcision.

Even if circumcision did protect the men, there is no evidence that it helps prevent transmission from HIV positive men to women, a concern reiterated by the Secretary General of the Treatment Action Campaign, herself a Xhosa. She commented that 'most new incidences of HIV are among women'.

A trial in Uganda reported in The Lancet found that rates of transmission to women increased with circumcised men. The trial had to be abandoned for ethical reasons.

In America, recent research has found that circumcision does not reduce transmission rates among gay men. Dr. Peter Kilmarx, of the U.S. Centers for Disease Control and Prevention said that circumcision "is not considered beneficial" in stopping the spread of HIV through gay sex.

Previous research has suggested circumcision doesn't make a difference when anal sex is involved. The latest study, by CDC researchers, looked at nearly 4,900 men who had anal sex with an HIV-infected partner and found the infection rate, about 3.5 percent, was approximately the same whether the men were circumcised or not. Presumably the same applies to men having anal sex with women.

KwaZulu Natal Province has one of the highest HIV infection rates of any South African province. If circumcision does not reduce transmission rates then thousands of young men's lives and well-being will have been put at risk for nothing. Women's lives will also be at risk as these men become their sexual partners. There is still no conclusive evidence that circumcision works any better than good hygiene.

The trial in the Lancet reported above concluded that 'Condom use after male circumcision is essential for HIV prevention'.

Saturday, 16 January 2010

Dr Kendall's Patent Homeopathic Remedies

Dr Kendall's Patent Home Cures are proud to announce the launch of their new Homeopathic Remedies Range. The first product in this new range, which is planned to expand alongside our other best-selling Home Cures, is Dr Kendall's Homeopathic Contraception.

Non gravida 30C is made from extract of guaranteed 100% pure organic Brazilian rainforest babies.

For the uninitiated, homeopathy works on the principal of like curing like or of like preventing like, as eminent homeologist Crispian Jago explains. A remedy containing babies therefore prevents pregnancy.

Conventional contraceptive pills are full of harmful, unnatural chemicals with side-effects and have a failure rate of up to 8%, which means that for every 100 times you have sex, you will get pregnant eight times. The numbers do not lie. Do you want to take that risk? Dr Kendall's Homeopathic Contraceptive pills are for every woman who cares about her body.

After harvesting, the babies are washed inside and out in spring water to guarantee the purity of the remedy. They are then processed at Kendall Laboratories in our Kendall's Baby Masher (patent pending). The concentrated extracted essence is prepared for you in pills of the finest Saccharum officinarum for your health and well-being.

Dr Kendall's Home Cures have been trusted and true for over 100 years. They are available now for online ordering. No prescription needed!

Support the 1023 campaign and the mass homeopathy overdose on January 30th.

Tuesday, 12 January 2010

Always let your conscience be your guide?

The General Pharmaceutical Council (GPhC) has been given the power in the draft Pharmacy Order 2009 to set standards and make rules in a number of areas including education and training, conduct, ethics and performance in relation to owners of pharmacies and superintendent pharmacists.

They have held a consultation on these standards and I have written a response for the National Secular Society **. This is an edited version of it. It's more formal than my usual style as it's an official response.

The National Secular Society is responding to Questions 3 and 8 in relation to pharmacists claiming the right to refuse to dispense emergency contraception (EHC) because it is against their conscience. These will be dealt with together as the concerns are overlapping. This is a particular concern because, as an article in the Journal of Medical Ethics reports, there is ‘a stampede of pharmacists claiming such a right’.

Question 3 - The GPhC is committed to embedding Equality and Diversity at the heart of everything it does. Do you think that the draft standards support this commitment?

Question 8 - Do you agree that there should be provision within the Code which allows personal beliefs of registrants to prevent them from providing a particular professional service? (subject to ensuring that patients and the public are referred to alternative providers of the service they require)?

If conscience is allowed to over-rule over customers’ needs, then there is no equality, there is a hierarchy of rights with the pharmacists’ taking precedence. Diversity would not be supported either if the pharmacist's personal needs prevailed. Customers' Human Rights should be respected; allowing a conscience clause compromises this.

Allowing pharmacists a choice about whether they provide EHC potentially denies customers any choice in a way that may affect them – and their partners and families - long-term if they are then forced to have an abortion or raise an unplanned-for child. If a privilege or advantage accorded to one group disadvantages another, then it should not be an assumed right.

Selling EHC is part of the job pharmacists have voluntarily chosen, been trained and employed to do, generally at public expense. It is therefore reasonable to expect them to fulfil their duty to the public as a whole. Pharmacists whose conscience creates conflict in this area should either set aside their personal beliefs for the benefit of the customer or work in an area of practice where such conflicts do not arise.

A conscience provision would conflict with the following section from The General Pharmaceutical Council Regulatory Standards Development Programme:

Standards of conduct, ethics and performance
As a pharmacist or pharmacy technician you must:

1. Make patients and the public your first concern
You must:
ensure the interests of patients and the public are not compromised by personal or organisational interests, incentives, targets or similar measures
2. Respect the dignity, rights and beliefs of patients, the public and others.
You must:
• treat patients, the public and others politely and considerately, respecting their cultural differences, values and beliefs
ensure your views about a person’s lifestyle, beliefs, race, gender, age, sexuality, disability, or other perceived status do not prejudice the services they receive
5. Listen to patients and the public and respect their choices.
(our bold)

These points all clearly put the customers’ health and well-being above the interests of the pharmacist, who may not discriminate against anyone on the grounds of personal belief.

Moreover, current legislation does not allow pharmacists on the pharmaceutical list a right to deny customers drugs on conscience grounds. National Health Service (Pharmaceutical Services) regulations 2005 Schedule 1, Part 2, Paragraph 9 outlines the terms that apply to pharmacists on an NHS pharmaceutical list. The circumstances in which they may refuse to supply a drug do not include issues of conscience. Paragraph 4 states that:

Dispensing services
4. A pharmacist shall, to the extent that paragraphs 5 to 9 require and in the manner described in those paragraphs, provide proper and sufficient drugs and appliances to persons presenting prescriptions for drugs or appliances by health care professionals in pursuance of their functions in the health service, the Scottish health service or the Northern Ireland health service (our bold).

As there is no statutory basis for a conscience opt-out, in an extreme situation there is the potential for a pharmacist or pharmacy to be sued if actions resulted in the customer suffering.

Any pharmacist who decides not to stock certain medical products on conscience grounds is potentially not fulfilling requirement 4 and paragraph 9 mentioned above. We believe their names should be removed from the NHS list for failure to comply.

Many customers who need EHC are in a vulnerable position. It is difficult to envisage the circumstances in which pharmacists could communicate conscientious objections to patients without also communicating personal judgement. Any mention of the pharmacists’ beliefs could put pressure on the customer and cause distress.

Teenage pregnancy rates in the UK are among the highest in Europe. Any behaviour likely to worsen this situation should be very closely scrutinised before being permitted.

There is strong evidence that customers are not being properly served or referred, both with OTC purchases and when they have a prescription; there are also reports of pharmacists showing no respect, offering no privacy, being clearly judgemental and giving no clear referral. The retention of an unfilled prescription should be a disciplinary offence.

A further concern is that allowing a conscience opt-out in one area may lead to a growing number of refusals on broader grounds. In America, for example, some pharmacists are now refusing to sell any form of contraception, and may refuse EHC even when a woman has been raped.

We have details of an NSS member who, while on holiday in the US, had to go to ten pharmacists before he could find one who would sell EHC for his wife after a condom failed.

As the conscience opt-out expands its reach in the US, ambulance drivers have refused to transport patients for abortions and a fertility clinic has refused to assist a
gay woman. If conscience clauses are allowed, it could for example be expected that some dispensers will refuse to provide products tested on animals if this is against their beliefs.

The article Private conscience, public acts in the New England Journal of Medicine looks at the situation in both the US and the UK. It identifies the problems that can arise once opt-outs are allowed. The authors say that ‘conscience is a poor touchstone; it can result in a rule that knows no bounds (…) there comes a point at which tolerance breaches the standard of care’. It also states that ‘Conscience is a burden that belongs to the individual professional; patients should not have to shoulder it’.

There is much academic evidence proving that allowing conscience opt-outs to pharmacists endangers the health and well-being of women, particularly in the lower income groups.

The NEMJ article states that an expanding list of products that pharmacists may object to providing leads to ‘the randomness of individual morality’. Customers ‘need assurance that the standard of care is unwavering’. They are very unlikely to check out in advance whether local pharmacists will provide certain services on the off-chance of needing them in the future; it is most likely that they will not find out until they urgently need a service, only to find it denied them.


The Guidelines state that a pharmacist must:
inform relevant persons or authorities if your personal beliefs prevent you from providing a particular professional service and ensure patients and the public are referred to alternative providers of the service they require.

While referrals may appear a workable solution, in practice it may not always be possible for the customer to find an alternative. For example, in rural areas or late at night it may be either impossible to find another pharmacist or possible only if the customer travels a long distance and pays transport costs. For women, there may also be safety issues involved in such travel. Any long journey may have to be explained to parents or family members, which could put the women in a very difficult position.

If a pharmacist does refer a customer to another dispenser, there are no guarantees that this one will dispense the EHC either.

In addition, although the window for taking EHC is 72 hours, the longer the woman is forced to wait, the greater the potential risk of pregnancy and associated health risks.

If a pharmacist does not comply with the obligation to refer, there is currently no way of monitoring this unless a formal complaint is made. This may be a particular problem in small or close religious communities. Women and their partners may lack the confidence, information or freedom necessary to make a complaint.

The NSS therefore recommends that pharmacists are not permitted a conscience opt-out relating to EHC or to any other treatment in the interests of equality, diversity and health or well-being.

If, against our recommendation, pharmacists are allowed a conscience clause then:

1. Pharmacies must ensure that there is a qualified pharmacist on duty at all times who will provide all legal products without the interference of conscience.
2. Those pharmacists wishing to exercise their conscience should be required to indicate the areas/circumstances in which they reserve the right to do so. Local GPs, the PCO and the GPhC should be formally notified
3. There should be clear signs stating that dispensers may/will not provide certain products
4. It should be mandatory for each refusal to be formally documented with copies given to the customer, the PCO and the GPhC. Refusals should be followed up to ensure an adequate service in all areas. Failure to provide a completed form to all mandatory recipients should be a disciplinary offence.
5. Pharmacists must be able to guarantee that any other dispenser they refer a customer to will definitely dispense the product. If there is no guaranteed alternative, they must then dispense it themselves.
6. Applicants for posts should make their position clear at the time of application and this should be notified to the PCO and GPhC.

**The National Secular Society campaigns for a society in which everyone is free to practice their faith, change it or not have one, according to their conscience. Our beliefs or lack of them should not put us at an advantage or disadvantage. Religion should be a private matter, for the home and place of worship; it must not have privileged input into politics, legislation, education or healthcare. Religious rights and claims of conscience should not take precedence over the Human Rights of others.

UPDATE: 9 March 2010
A woman in Sheffield was refused the contraceptive pill by a Lloyds pharmacist who said "I don't give out contraceptive pills because of my religion". Janine Deeley takes the pills partly for endometriosis and has been using the pharmacy, which adjoins the doctor's surgery, for years.

She was told by the pharmacist that she could go to another pharmacy or come back the next day when someone else was on duty.

Lloyds are investigating and have apologized to Deeley.

A spokesperson from the Royal Pharmaceutical Society of Great Britain said: "while the Code of Ethics and Standards does not require a pharmacist to provide a service that is contrary to their religious or mortal belief, any attempt by a pharmacist to impose their beliefs on a member of the public seeking their professional guidance, or a failure to have systems in place to advise of an alternative source for the service required, would be of great concern to the RPSGB and could form the basis of a complaint of professional misconduct."


It has been decided by the GphC that pharmacists can refuse to dispense anything that is against their beliefs and that they 'may' be forced to refer patients to other pharmacies. This is not good news.


Three and a half years on, conscience opt-outs are still causing problems, as this story shows. A Catholic chemist at Boots harangued a woman and refused to refer her to another pharmacy. He did eventually give her what she needed but the RPSGB Code is clearly being breached. Much better monitoring and education of pharmacists is still needed.

Monday, 4 January 2010

Who's The Daddy? Why polyandry is a bad idea

Saudi writer Nadine Al Bdair says polyandry should be allowed now that DNA testing can prove who is the father of a child.

She wants Muslim scholars to allow women to marry up to four husbands in the same way that men can have up to four wives.

"Traditionalists argue that Islam forbids women to marry more than one man at once to determine the fatherhood of the child in case the woman becomes pregnant. This argument has now collapsed because modern science can identify the father of any child through DNA testing," she said.

Responses have varied; some have taken her article as a protest against inequalities in Muslim marriage laws. Secularist commentators are talking about freedom of expression. Lawyer Khalid Fouad Hafez, who is also the Secretary General of the People's Democratic Party in Egypt has denounced it as blasphemy and a call for an immoral act that is a violation of the Egyptian criminal code. He said that unless she repents, the law must take action to protect (Muslim) society against her call to 'legalise adultery'.

To take a step back from the reactions, would DNA testing really do women any favours? Would it liberate women, Muslim or otherwise? Do they really want polyandry?

In the UK, there are over 200,000 paternity tests a year, twice that many in America - and those are only the official figures, not counting home testing. There is a long article in the New York Times about the emotional devastation caused to men who discover that their children are not really theirs. Stories appear in the media every now and then claiming that one in ten men are unwittingly bringing up someone else's child or, in China, nearly one in three men. Companies offer home testing kits with names like Peace of Mind DNA Paternity testing (in Ireland, for around 700 euros as peace of mind doesn't come cheap).

Peace of mind is the last thing these tests offer; they sell suspicion and stories about false paternity feed the doubt.

While Al Bdair may be making a valid point about injustice in the Muslim world, her solution would create more problems for women, Muslim or not. If testing became widespread, men would more readily suspect that they might not be the father, that women are not to be trusted. Women would be guilty until proven innocent. In more severe Muslim societies, it can already be next to impossible for a woman to clear her name, even if raped - with fatal consequences.

Marriage was historically an institution to produce legitimate heirs, which is why virginity was prized in a bride. Childbirth was all about the transfer of land, money and power in a time when fatherhood could not be guaranteed. Women started giving birth on their backs so that men could see the baby coming out and be sure it had not been switched for another. In some societies, men would favour their sisters' children who were certain to share at least some of their genes (or in earlier terms, to share a common ancestor). Arranged marriages in some cultures are still about a union of resources.

In behaviourist terms, marriage is a form of mate guarding, ensuring that females don't sneak off in search of better males with better quality sperm, knowing that the mate would rear the results. In other animals, guarding is a pretty hit and miss affair.

Even when couples marry for love, men may choose to raise someone else's children but do not want to be fooled into it. Even so, some research has found that stepchildren are more likely to be abused - the so-called Cinderella effect (although this is not without its critics). Adoptive parents prove that it is possible to raise other people's children but again, this is a choice.

Not only do stories about false paternity create a climate of suspicion, they are often based on a misreading of statistics. If 28% of paternity tests in a sample come up negative, this does not mean that 28% of men in the whole population are not the father of their children as media stories would indicate. For a start, men who get tested may have more of a reason to - often because the CSA is involved.

In the West there is still a lingering suspicion about women based on Judeao-Christian tradition. There are endless misogynistic quotes but here are two typical ones:

No wickedness comes anywhere near the wickedness of a woman.....Sin began with a woman and thanks to her we all must die (Ecclesiasticus 25:19,24).

What is the difference whether it is in a wife or a mother, it is still Eve the temptress that we must beware of in any woman......I fail to see what use woman can be to man, if one excludes the function of bearing children. (St. Augustine of Hippo: 354 to 430 CE).

This may seem a bit extreme but vestiges of the old virgin-mother-whore career options for girls do still lurk, as we see when promiscuous boys are heros and promiscuous girls are slags. Women's sexuality still has a long way to go to be the equal of men's.

There is also the lingering idea that childbirth is the most important thing a woman can do. This idea is perpetuated even by some women, who look down on childless women as excluded from their special club.

While many men of course do not worry about their paternity, relatives still routinely tell the father of a newborn how much it resembles him, a cultural left-over from a time when having the same nose was the only way of judging shared genes.

With or without DNA testing, polyandry would not easily allow women more sexual choice or financial support or equal social status. It would not even the playing field. Four husbands would mean four men wanting to pass on their genes, so increased pregnancies and child-rearing for the woman, effectively reducing her to a walking womb.

One man can impregnate countless wives in a short time but a woman can only provide offspring to one mate every nine months. This would lead to the husbands competing for womb-time. It's why the harem is common in nature but not polyandry. How do you keep the other husbands interested while waiting for their turn to come, if it ever does? And how would the men's wills work?

Fraternal polyandry, as practiced in a few remote communities in India, Nepal, Sri Lanka and Tibet, at least means the men all have some genetic investment in the children - as long as they can be sure that one of them really is the father. Multiple husbands, especially in more traditional societies, would mean multiple cooking, laundry and cleaning. And having four husbands would mean three other women with none.

Bdair may have done what she set out to by starting a heated debate on women's rights, but perhaps next time she could come up with a better idea to base it on. And that's without even going into what's best for the children. Any woman who thinks that testing is a good idea should read Othello.