I try to be a reasonably reasonable kind of person. I like to know the why, not just the what. I rarely take anything for granted. And then, sometimes, I’m just a quack with a persistent bee in my bonnet (if you’ll forgive the mangled metaphor). For years I have scoffed at those who get the flu shot. And I’ve raved and ranted against them, too. The flu vaccine is useless at best, I’ve always said. And probably worse than that. (I’m also not a fan of Gardasil, which in my mind is way worse than useless at best.)

Now it turns out doctors are starting to catch up with my anti-flu-shot quackery:

A “perplexing” Canadian study linking H1N1 to seasonal flu shots is throwing national influenza plans into disarray and testing public faith in the government agencies responsible for protecting the nation’s health.

Distributed for peer review last week, the study confounded infectious-disease experts in suggesting that people vaccinated against seasonal flu are twice as likely to catch swine flu.

The paper is under peer review, and lead researchers Danuta Skowronski of the British Columbia Centre for Disease Control and Gaston De Serres of Laval University must stay mum until it’s published.

Met with intense early skepticism both in Canada and abroad, the paper has since convinced several provincial health agencies to announce hasty suspensions of seasonal flu vaccinations, long-held fixtures of public-health planning.

“It has confused things very badly,” said Dr. Ethan Rubinstein, head of adult infectious diseases at the University of Manitoba. “And it has certainly cost us credibility from the public because of conflicting recommendations. Until last week, there had always been much encouragement to get the seasonal flu vaccine.”

Not only that: I was at a social gathering lately and was chastised by more than one guest (including one who is a nurse) not to shake hands and kiss friends (I’m French; the kiss-on-both-cheeks thing is something I do without thinking). There are messages on the radio reminding me to sneeze in my arm, etc. And I just want to scream. I’m healthy and not completely stupid. I know how to deal with the flu (stay home and sip chicken-noodle soup). It’s actually quite simple, and the more “experts” try to meddle with how normal people deal with normal health questions, the more they mess things up.

A fine post by Paul Tuns. Especially this:

The problem is that pregnant women are routinely tested to see if their child has a genetic anomaly for which there is no treatment. Doctors, who can’t stand to do nothing, offer what they can: abortion to get rid of the “problem”. This leads to a vicious cycle; I’ve talked to doctors who are concerned that with fewer Down Syndrome children being born, there is less impetus to do the type of research which could enrich the lives of those who survive the womb for nine months because there isn’t enough demand. Future lack of resources to help parents of Down Syndrome children will only encourage more parents to abort such children in the future.

Testing to see if the child has some “problem” for which there’s no treatment is one of those “illusion of technique” traps – better living through science (except of course for those whose lives are cut short in the name of perfection). Expecting mothers, not all of whom are geneticists, are often made to take those tests as a matter of routine because that’s just what’s expected, especially if you’re an older expecting mother. But those tests that determine (that’s assuming the tests are accurate, not an altogether water-tight assumption) whether a fetus has a condition for which there is no treatment are not medicine.

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Andrea adds: This breaks my heart.

The Washington Post cites Skotko’s research indicating that 92 percent of women who learn they are carrying a baby with Down syndrome choose to abort the pregnancy. That is more than nine out of ten.

Does anyone know when it comes to ultrasounds then, what is the point? Because I’ve always said I would not have one, period. But are there any conditions that can be viewed in utero for which abortion is not the answer? (As in, if you see something in the fetus early there is a bona fide treatment?)

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Rebecca adds: “Does anyone know when it comes to ultrasounds then, what is the point? Because I’ve always said I would not have one, period. But are there any conditions that can be viewed in utero for which abortion is not the answer? (As in, if you see something in the fetus early there is a bona fide treatment?)”

I maintain that there is good reason to have these tests – maternal blood screening and ultrasound, which are non-invasive for the baby – even for people who would not consider abortion no matter what the result.  The major downside is false positives for problems, but a good obstetrician or radiologist will explain what are the odds of a false positive (and negative) to women being tested.  There are good medical reasons for finding out about problems in utero.  In some cases, babies can have surgery prior to being born, which can repair some otherwise fatal defects.  In others, when parents and doctors are aware of major problems, they can do a C-section and transfer the baby to immediate surgery; I know a healthy teenager who had a severely malformed abdominal wall, and since it was detected in utero, this is what happened.  If he’d gone through a vaginal birth, or not been taken immediately into a prepared operating theatre, he would likely be dead.  Down Syndrome in particular causes a higher risk of heart defects that can prove fatal at or shortly after birth, so it’s good to know if your child has this problem, so you can ensure optimal care at delivery.

The other big reason in my opinion is to prepare yourself psychologically.  Sarah Palin talked about being overjoyed when her son was born; she’d already come to terms with his medical condition, so the birth was a joyful occasion, not mixed with grief as it would be it were also the occasion on which you first learned your childhood had a lifelong disability for the family to cope with.  When major surgery is needed right after birth, it’s a lot easier on the family if it’s not a surprise, if they know what to expect and have made arrangements to help them all get through it.  Coping with a new baby is stressful and exhausting even when everything is perfect; coping with major surgery for your newborn would be a excruciating.  If that could be mitigated by some knowledge in advance of what the risks are and what’s likely to happen, I’m all in favour.

I fully support the choice to refuse prenatal testing if that’s what the mother wants.  But diagnostics themselves are not the problem, it is the mentality of the people within the system and how they use diagnostics.  These tools can certainly be used to mark some unborn children as unworthy of life.  But they can also be used to ensure best outcomes and the smoothest transitions even for babies with severe problems.  There is no inherent contradiction between being pro-life and being in favour of prenatal testing.

(I don’t discuss amnio because that, unlike maternal blood screening and ultrasound, does present a risk to the baby, with between .5% and 2% of amnios causing miscarriage, depending on when, how and where it’s done.  That’s a whole separate set of ethical issues.)

Further,”as commenters point out, there are other reasons that don’t involve defects or disease.  The reality of medicine today is that, while OBs rely less and less on manual palpation to evaluate pregnancies, it is not unheard of for a twin’s existence to go unnoticed until the birth.
Apart from the shock and logistics for the parents, this is medically
risky: for multiple births, it’s desirable to have extra supplies and attendants, as well as the ability to do an emergency C-section.  And less critically, ultrasound can be a great way of making a pregnancy seem real, and start a sort of proto-bonding.  I don’t know anybody who hasn’t teared up the first time they saw their baby on a scan, even if it’s still at the “peanut with a heartbeat” stage (6 or 7 weeks, if I recall correctly.)”

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Andrea again: Thanks for all the thoughtful comments. I like what Rebecca said about it being the mentality–not the tools. I have two friends who were offered testing in order that they might abort. (It was expressly stated.)

Which is also extraordinarily heart-wrenching. A woman who was implanted with someone else’s embryo is preparing to give birth and hand over the baby to the biological parents. There was no easy way out in this case – how do you justify aborting someone else’s baby? How do you carry and deliver someone else’s baby? I can’t imagine how hard it must be for everyone involved, but I’m glad they chose the option that would let the baby live.

Here’s a fine puzzle for you: What do you tell your child when he comes home confused by a classmate who went from 12-year-old boy to 12-year-old girl over the summer vacation? That you’re pretty confused, too?

A BOY aged 12 turned up at school as a GIRL – after changing sex during the summer holidays.

Teachers called an emergency assembly to order fellow pupils to treat him as female.

The lad, whose parents have changed his name to a girl’s by deed poll, arrived in a dress with long hair in ribboned pigtails. He is preparing for sex-swap surgery.

Angry parents told yesterday how their kids were left tearful and confused after school staff announced the boy pupil was now a girl.

They said the head teacher should have informed them in advance of the “sex change” so they could prepare their sons and daughters and inform them about gender issues.

Three things: 1) While I do not wish to diminish the pain that individuals caught in the wrong gender experience, isn’t 12 a bit early to go ahead with gender reassignment? 2) Why didn’t the school warn other parents? You can’t expect 12-year-olds to accept such concepts without some kind of preparation, and it’s not nice to surprise people that way. And 3) What a stupid thing to do! By not warning the other parents and giving them a chance to prepare their kids so they could deal with their sex-swapping classmate, they made it even harder on said classmate:

[Parents] added that the school’s failure to do so [give them a heads-up] had left the boy to suffer cruel taunts and bullying.

One mum said: “They behaved appallingly by throwing this hand grenade into the room and then leaving the inevitable questions about it for unprepared parents.

“Maybe we could have explained sexual politics and encouraged our kids to be more sensitive if we’d had a chance to be involved.”

So here’s the lesson: If you’re going to let children undergo sex-change operations, you must be prepared to do some work to ensure other children react reasonably well to the change. I do think 12 is way too early for this kind of operation, but that doesn’t mean I’m prepared to treat this kid and other children in his situation badly. Dressing up a 12-year-old boy as a girl and sending him to school with no preparation is dumb and stupid and cruel.

Check out perspectivesonagirl.ca, “Girl Guides of Canada’s First Annual Online Film Festival”. It’s a pretty clever-looking website, and some of the films are quite cute. Like this one.

[youtube:http://www.youtube.com/watch?v=6fkP0grx9KY]

At the risk of sounding like a crusty old goat (again), isn’t this a high price to pay for sterile sex? We’re talking about teenagers, here, not adult women.

When it comes to birth control, it’s widely believed that the lower the hormone dose, the better. But according to a new study, pills with lower levels of estrogen may interfere with the bone development of teenagers. Dr. Jan Stepan of Charles University in Prague found that teens who took low-dose pills experienced lower levels of bone growth and bone density compared with those who took higher-dose pills. The reason, says Stepan, is that lower levels of estrogen suppress the body’s release of the hormone but does not fully replace it.

I dislike stuff like that, because to me behaviour is something one controls using one’s will power. Saying something unfavourable is “caused” by one’s genes is a great way to excuse bad impulse control, and my inner Calvinist wants to tear her hair out in frustration. Not everything is as scientific as some people believe.

The fact that children raised in homes without a dad have sex earlier is down to their genes, say US researchers.

The study tested for genetic influences as well as factors such as poverty, educational opportunities and religion.

The more genes the children shared, the more similar their ages of first intercourse regardless of whether they had an absent father or not.

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Rebecca adds: I think there’s something to this (and I also think that having a genetic predisposition to something – drinking, anger, unacceptable paraphilias – doesn’t give you a blank cheque to indulge, although it does mean you deserve extra credit for being disciplined.)  J. Philippe Rushton, not by any means uncontroversial but not automatically wrong on that account, points out that animals and their reproductive strategies fall along a continuum, with frequency of reproduction increasing as the amount of effort put into parenting decreases. Humans, horses and elephants are at one end of the extreme; the vast majority of their pregnancies are singletons, gestational periods are long, and offspring require sustained and expensive care before they are autonomous. Rabbits and mice are at the other end for mammals, having large litters few of whom need to make it to adulthood for the genes to be passed on, and shorter gestational periods. Non-mammals trend even more strongly towards frequent reproduction and low investment parenting; think of the number of tadpoles produced by one pair of frogs.

Rushton suggests that humans show variation on this continuum by group. We would expect that a high frequency, low involvement approach would manifest biologically in greater frequencies of multiple births, slightly shorter gestation, and earlier sexual maturity. He gets people smoking out their ears by grouping different races along this continuum. But we can dispense with that dimension entirely and still consider a genetic connection here. It’s notable, though, that minorities with conservative social values and largely intact families seem to suffer vastly less from “racism” than other groups with particularly high out of wedlock births and their accompanying ills; if racism were indeed the causal factor, it’s puzzling that it harms some “non-whites” so much more than others.

Another, less inflammatory, approach is the “cads vs dads” theory. This holds that men in particular can ensure that their genes are passed on in one of two ways: by having relatively few children and focusing extensively on their nurturing to adulthood (dad), or by fathering multiple children and relying on the odds that some of them will make it to adulthood even with his dissipated involvement and resources (cad). What I would find really fascinating would be a look at whether sexual maturity comes earlier to children raised without fathers, since this is more a result of nature than first sexual activity which, being largely behavioural in a way that physical puberty isn’t, is a product of nurture.

A long piece on the harsh, cold reality of gender selection in India – especially in wealthier areas. Chilling.

Indian women of any class rarely make decisions about their reproductive choices themselves: Husbands and in-laws are usually intimately involved.

At a south Delhi abortion clinic this week, for example, five of six patients booked for appointments had been accompanied by their mothers-in-law. The clinic director, who did not wish to be quoted by name because of the sensitive nature of the subject, noted the large sign – which must, by law, be posted – saying sex determination was illegal and not offered there. Five of the 200 patients she sees each month are well into their second trimester, when fetal gender can be confirmed, and claim to already have daughters. She turns them away, fearing sex-based termination is their primary motive.

“But others lie, and how can we check? They say they have sons already, and came because of contraceptive failure, and that entitles them to abortion … and there is nothing I can do about that,” she adds.

He has been extraordinarily courageous in his fight against cancer. He will be missed.

[youtube:http://www.youtube.com/watch?v=WpmILPAcRQo]

From today’s Globe and Mail:

Contraception is a cheaper means of preventing climate change than conventional green technologies, The Daily Telegraph reports, according to research by the London School of Economics. “Every £4 [$7] spent on family planning over the next four decades would reduce global carbon-dioxide emissions by more than a ton, whereas a minimum of £19 [$34] would have to be spent on low-carbon technologies to achieve the same result, according to researchers. The report, Fewer Emitters, Lower Emissions, Less Cost, concluded that family planning should be seen as one of the primary methods of emissions reduction. The UN estimates that 40 per cent of all pregnancies worldwide are unintended.”

Just wondering: How do they estimate that number of unintended pregnancies? Do they go around asking pregnant women how they feel about things? Do they just pick a number at random?

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Tanya’s mind reels: What about the greenhouse gasses emitted during the production of these “family planning” methods? Oh, and the effects of their subsequent “disposal.” Did you know that 100% natural latex is completely biodegradable? But that nearly all condoms are not made of 100% natural latex, but contain synthetics? Furthermore, one of the main causes of yeast infections among women is condom and/or spermicide use. Clotrimazole, which is the leading treatment for yeast infections, is associated with major environmental risks. Oh, I could go on and on…