Kookaburra with meat

Kookaburra with meat
photo by Lander 777

Tuesday, June 19, 2012

International opportunity opens from the demise of the SMH

Yesterday's announcements (1, 2,3)  about the Sydney Morning Herald show its death is not far off.  It's been on the cards for years. Once a must read - the daily agenda setter for the news cycle - it has dwindled into a cheap parochial pamphlet, little better than the free suburban throwaways.

If the decline wasn't yet terminal, Gina Rinehart's muscling into a controlling position on the Fairfax Board will cement it. In the absence of any public explanation from her, it is impossible to imagine that her motive is not to make Fairfax into a conservative organ to match her politics. This will, of course, kill the SMH; probably her intention. Will the inevitable drop in share price give her pause? I doubt it.

(Both sides of Federal politics correctly call on her to subscribe to the Fairfax charter of independence, to no avail. Once again, Malcolm Turnbull shows how easy it would be to support the Federal Liberals if he were still leader).

The idea that changing to a tabloid format will save the SMH is absurd. If this has worked for The Times and The Independent, surely this is because of a daily commuter market 3 times that of Sydney. The UK and the US have always had the population levels to sustain a range of quality end newspapers, whereas there are only two cities in Australia that have (until their decline in recent years) sustained a quality daily each.

Newspapers are in decline all around the world. ABC chief, Mark Scott (@abcmarkscott), gives a good run down about the inevitable forces for this here.  Only those news organisations that can maintain a global readership will survive, if by "survive" we mean "continue to offer quality, editorially-checked, truth-based journalism".    Two plausible candidates for survival are The Guardian and The New York Times. (Or there are quality conservative competitors that could do likewise). 

No doubt contributing to the SMH's decline, I have found that I now read those sources more often than the Herald, relying on Twitter or email for local parochial stories.

So there is an opportunity for international intelligent news organisations to fill the gap that the SMH will be leaving.  If The Guardian or New York Times opened a Sydney Bureau - with, say, 10 journalists - they could easily capture the Sydney readership that has and will continue to abandon the Herald.   There must be 10s of thousands of daily readers who would subscribe to a Guardian- Sydney or NYT-OZ with a mixture of quality fact-checked international news gathering, and spattering of parochial daily Sydney stuff just to keep us in touch.

So there's an opportunity. There's money in it for the first international quality masthead to pick it up.

[Update - January 16 2013]  So it has taken The Guardian less than 6 months to pick up my suggestion. Today they announced they would publish an online Australian edition to pick up on their existing Australian readership, and engage with the Asian region. Its editor, Alan Rushberger, described it as the "natural next step" for the publication".

Lovely that The Guardian is reading my blog and taking my advice to heart.

Time for the New York Times to follow suit. 

Both of these papers should pick up some of the quality journalists that used to work for the SMH.

If it does so, it will be the end of the SMH, I have no doubt. It has only gone down hill further in the 6 months since the first post.

Saturday, April 14, 2012

Was Darwin a theist? - the Dawkins v Pell debate

The atheism versus religion debate on the Australian Broadcasting Commission's Q&A program between Richard Dawkins and the Australian Catholic Church's Cardinal George Pell has sparked a number of controversies.

One of the more curious is that both sides sought to enlist the authority of Charles Darwin. Pell tried to advance a relatively sophisticated argument from the religious side, which might be summarised as "even if Darwinian evolution is true, it doesn't explain the existence of the universe in the first place". Pell said Darwin accepted this argument and had said "I have to be ranked as a theist".

By Catholic Church (England and Wales) on Flickr
By Shane Pope on Flikcr

Here's the Darwin-was-a-theist exchange:

GEORGE PELL: Well, science and religion are two different activities and in the Catholic Church you can believe, to some extent, what you like about evolution. I think Darwin made a great contribution. I remember talking with Julius Kornberg, a very distinguished biologist, and he's worked with ants for years and he said, you know, he's managed to change them by changing the conditions but there are a number of things that evolution doesn't explain. Darwin realised that. Darwin was a theist because he said he couldn’t believe that the immense cosmos and all the beautiful things in the world came about either by chance or out of necessity. He said, “I have to be ranked as a theist.”\ 
RICHARD DAWKINS: That just not true. 
GEORGE PELL: Excuse me it’s... 
RICHARD DAWKINS: It’s just plain not true. 
GEORGE PELL: It’s on page92 of his auto biography. Go and have a look.

And at that point the host veered the exchange in another direction. But look it up I did. And the news was not good for Pell on a couple of fronts.

First, (and this I admit is a pedantic point) Darwin says nothing on page 92 of his Autobiography about being a theist. It is on page 93 that Darwin says "I deserve to be called a theist". So Pell was literally wrong. 

If that was all there was to the issue, I'd give the points to Pell. After all perhaps the paginations on some editions may differ. Surely the bigger point was that Darwin thought of himself as a theist, right?

Well, no. In the context immediately before and after these words it is clear that Darwin is speaking about an earlier time in his life and explaining why he considered himself agnostic. Here's a larger slab from the full text: 

Another source of conviction in the existence of God, connected with the reason and not with the feelings, impresses me as having much more weight. This follows from the extreme difficulty or rather impossibility of conceiving this immense and wonderful universe, including man with his capacity of looking far backwards and far into futurity, as the result of blind chance or necessity. When thus reflecting I feel compelled to look to a First Cause having an intelligent mind in some degree analogous to that of man; and I deserve to be called a Theist.

This conclusion was strong in my mind about the time, as far as I can remember, when I wrote the Origin of Species; and it is since that time that it has very gradually with many fluctuations become weaker. But then arises the doubt—can the mind of man, which has, as I fully believe, been developed from a mind as low as that possessed by the lowest animal, be trusted when it draws such grand conclusions? May not these be the result of the connection between cause and effect which strikes us as a necessary one, but probably depends merely on inherited experience? Nor must we overlook the probability of the constant inculcation in a belief in God on the minds of children producing so strong and perhaps an inherited effect on their brains not yet fully developed, that it would be as difficult for them to throw off their belief in God, as for a monkey to throw off its instinctive fear and hatred of a snake.I cannot pretend to throw the least light on such abstruse problems. The mystery of the beginning of all things is insoluble by us; and I for one must be content to remain an Agnostic.

Darwin was writing this in 1876. He published Origin of Species in 1859. And he was writing it in the late 1830s, That is, he is writing about believing in theism up to 40 years earlier, a view he had now abandoned.

This is part of a a much longer passage from pages 85 to 96 of the Autobiography which shows Darwin had been a Christian believer at the time of the voyage of the Beagle (1830s). He gradually but certainly abandoned Christain belief but appears to have remained a deist, or non-christian theist; and that appears to have been his position at the time of writing the Origin of Species (late 1830s to late 1850s). By the time of writing his Autobiography he appears to be a deist agnostic. (ie the God he was uncertain of the belief in was a deist entity rather than a Christian one). The only remaining argument about which he seems to hold doubt is the question of a first cause within the universe. He rejects arguments from biblical revelation, design and widespread personal conviction. He accepts the argument from the existence of evil.

But perhaps all of this is of little help to the debate anyway. Why should we accord the 1876 Darwin greater status than the 1859 or 1838 Darwin? The 1838-59 Darwin, after all, was in the midst of developing the theory of natural selection, surely  one of the greatest intellectual achievements of the 19th century. If, instead of expressing a view about theism, the ageing Darwin had disavowed the theory of natural selection, would we therefore feel obliged to abandon the theory? No, I think. The theory stands or falls based on the evidence to support it. It does not depend on the identity of its author.  So really the whole question of what Darwin's views were at various times is really an appeal to an argument from authority - that is, a logical fallacy.

So the debate was a disappointment, right?

Well, some (here and here and including Dawkins, quoted here) have thought so, but in my view, no.

I actually found Pell's views on a number of issues unexpected and fascinating. No doubt through my own ignorance, I had not appreciated the apparent gulf between modern Catholic doctrine these issues and that I understand to be held by protestant evangelical churches, particularly in the US. Here are some examples of what I did not know about the beliefs of a Cardinal of the Catholic Church: 

When or who was the first human being?

We can't tell, says Cardinal Pell.
GEORGE PELL: "we can't say exactly when there was a first human but we have to say if there are humans there must have been a first one."

Is the story of Adam and Eve true?

No, says Cardinal Pell:
GEORGE PELL: Well, Adam and Eve are terms - what do they mean: life and earth. It’s like every man. That’s a beautiful, sophisticated, mythological account. It’s not science but it’s there to tell us two or three things. First of all that God created the world and the universe. Secondly, that the key to the whole of universe, the really significant thing, are humans and, thirdly, it is a very sophisticated mythology to try to explain the evil and suffering in the world.
TONY JONES: But it isn’t a literal truth. You shouldn't see it in any way as being an historical or literal truth?
GEORGE PELL: It’s certainly not a scientific truth and it’s a religious story told for religious purposes.

Do animals have souls?

Yes, says Cardinal Pell:
RICHARD DAWKINS: ....I’m not sure if it has a theological significance except that I think successive popes have tried to suggest that the soul did indeed get added, rather like gin to tonic, at some particular point during evolution; at some point in evolution there was no soul and then later there was one so it is quite an interesting question to ask. .... At what point did the soul get injected and what does the idea of original sin mean if Adam and Eve never existed?
TONY JONES: I’ll just quickly let you respond to that, George?
GEORGE PELL: Yeah, well, I mean God wasn't running around giving injections and if there is no first person we’re not humans.
TONY JONES: Where did the soul come from then in the point of evolution?
GEORGE PELL: The soul is the principle of life. There are animal souls.
RICHARD DAWKINS: Do jellyfish...
GEORGE PELL: All living things have some principle of life. An animal has a principle of life. A human has a soul, a principle of life, which is immensely more sophisticated.

Can atheists be morally good?

Yes, says Pell:
TONY JONES: .... about whether atheists can lead a good life and be good people and socially responsible and so on.
GEORGE PELL: Yeah, absolutely.
TONY JONES: You accept that?
GEORGE PELL: Yeah, absolutely.

Can atheists go to heaven?

Yes, says Pell:

GEORGE PELL:...from the Christian point of view, God loves everybody but every genuine motion towards the truth is a motion towards God and when an atheist dies, like everybody else, they will be judged on the extent to which they have moved towards goodness and truth and beauty but in the Christian view, God loves everyone except those who turn his back turn their back on him through evil acts. 
TONY JONES: So atheism is not an evil act?

GEORGE PELL: No, not - well, no, in most cases it’s not.

TONY JONES: So I guess to get to the point of the question, I suppose - I mean he may be having a little wager here but is it possible for an atheist to go to heaven?

GEORGE PELL: Well, it’s not my business. 
TONY JONES: You’re the only authority we have here. 
GEORGE PELL: I would say certainly.

GEORGE PELL: Certainly.
Now this would be news to Charles Darwin. In fact it might turn him back into a Christian. It appears he decisively rejected Christianity partly on the basis of the doctrine that non-believers would go to hell which he found "a damnable doctrine" (Autobiography p 87):
disbelief crept over me at a very slow rate, but was at last complete. The rate was so slow that I felt no distress, and have never since doubted even for a single second that my conclusion was correct. I can indeed hardly see how anyone ought to wish Christianity to be true; for if so the plain language of the text seems to show that the men who do not believe, and this would include my Father, Brother and almost all my best friends, will be everlastingly punished.
And this is a damnable doctrine.

Is there a hell?

I hope so, says Pell, but I hope there's nobody in it.
GEORGE PELL: ... The only people - well, one - I hope nobody is in hell. We Catholics generally believe that there is a hell. I hope nobody is there. I certainly believe in a place of purification. I think it will be like getting up in the morning and you throw the curtains back and the light is just too much. God's light would be too much for us. But I believe on behalf of the innocent victims in history that the scales of justice should work out. And if they don't, life is radically unjust, the law of the jungle prevails.

Catholic enlightenment?

Frankly, I would be surprised if these views had been expressed in Australia by a Cardinal, say, immediately after the second Vatican council. I think there has been some evolution happening in Catholic thinking. I know Catholics have never been quite so tied to biblical literalism as protestants. (No doubt this was part of the point of the reformation). Cardinal Pell is often referred to as a conservative Catholic, and sometimes spoken of as a possible future Pope. 

Some of these views suggest future grounds for accommodation with non-believers.

Thursday, January 26, 2012

Can anyone can call themselves a doctor in Australia?

Holidaying  recently on Queensland's Sunshine Coast, I was not surprised to see a thicket of compliementary and alternative health practitioners. (In Australia, CAM seems to be a coastal, touristy, warm climate phenomenon. I guess it has parallels in Florida, California, Thailand, and the Costa del Sol; but not so much in Aberdeen, Winnipeg, or  Reykjavik. Tell me if I'm wrong.)

What did surprise me was the use of the title "doctor" by a number of health practitioners who gave no appearance of having either a medical degree or a doctorate of any kind. 
One example is here:

(This photo is of a glass door leading into the practitioner's room. The door has the sign on it.  The practice is at a swimming pool which is reflected in the door, although the photo looks like the sign is hanging in empty space or superimposed on a photo of the pool. It was taken by me in January 2012).

This practitioner styles herself "Dr". She appears to have a bachelor's degree in science and a masters degree in health science specialising in osteopathy. She does not list a medical degree or a PhD or other doctorate in any discipline. The national register for Australian Health Practitioners confirms these as her qualifications.  

I make no criticism of this individual - it appears to be a common approach adopted by a number of health practitioners and approved by their regulatory authorities. But I do question the policy stance of the law if it really allows this to happen.

"This would never happen in NSW", I blithely thought to myself.  "This is Queensland after all - the State whose longest serving Premier tried to allow a Quack cancer therapist to set up shop.  Queensland is the flaky state".  Queensland has had its scandals and formal inquiries about bad medical practice.  I was sure things would be improving, but perhaps they hadn't yet touched the complementary and alternative fringe.

With an air of anticipatory southern state superiority, I looked up the NSW law on the question....oh, the shame! The NSW law appears not to prevent it either. 

I was sure there used to be a law against falsely calling yourself a doctor in NSW. There is for lawyers (see here and here). How had this happened? How could the rigour and esteem of the once proud NSW medical profession have been thrown to the wind? 

Well, until middle of 2010, it was a criminal offence in NSW for a person not qualified through a medical degree to represent themselves as a medical doctor or physician:
(1)  A person who is not a registered medical practitioner must not take or use any name, initials, word, title, addition, description or symbol which having regard to the circumstances in which it is taken or used indicates or is capable of being understood to indicate or is calculated to lead persons to infer that:
(a)  the person possesses a degree, diploma, or other qualification of a nature which would entitle the person to be registered as a medical practitioner, or
(b)  the person is registered as a medical practitioner under this Act.
Maximum penalty: 50 penalty units or imprisonment for 12 months, or both.
(2)  A person who is not a registered medical practitioner must not advertise himself or herself, or hold himself or herself out, to be a registered medical practitioner, doctor of medicine, physician, surgeon, legally or duly qualified medical practitioner, qualified medical practitioner or medical practitioner.
Maximum penalty: 50 penalty units or imprisonment for 12 months, or both.
In the middle of 2010, following an agreement by the Council of Australian Governments (COAG) in 2008, all states adopted a national law regulating the health professions based on the Queensland model.  The law covered 10 'professions': 

chiropractic, dentistry—including dental hygienists, dental therapists and dental prosthetists—medicine, nursing and midwifery, optometry, osteopathy, pharmacy, physiotherapy, podiatry and psychology
Section 113 of the law provides in part that 

A person must not knowingly or recklessly—(a) take or use a title in the Table to this section, in a way that could be reasonably expected to induce a belief the person is registered under this Law in the health profession listed beside the title in the Table, unless the person is registered in the profession...
"The Table" lists the following titles within various "health professions":

Aboriginal and Torres Strait Islander Health Practice
Aboriginal and Torres Strait Islander
health practitioner, Aboriginal health
practitioner, Torres Strait Islander health

Chinese Medicine 
Chinese medicine practitioner, Chinese
herbal dispenser, Chinese herbal medicine
practitioner, Oriental medicine
practitioner, acupuncturist


dentist, dental therapist, dental hygienist,
dental prosthetist, oral health therapist

 medical practitioner

Medical Radiation Practice
medical radiation practitioner, diagnostic
radiographer, medical imaging
technologist, radiographer, nuclear
medicine scientist, nuclear medicine
technologist, radiation therapist

Nursing and Midwifery
 nurse, registered nurse, nurse practitioner,
enrolled nurse, midwife, midwife

Occupational Therapy

 occupational therapist
pharmacist, pharmaceutical chemist
 physiotherapist, physical therapist
podiatrist, chiropodist

The key point is that the terms "doctor", "physician" and "surgeon" do not appear in the Table above. While nobody who is not registered as a "nurse" can use the title "nurse" in a way that could reasonably be expected to induce the belief that the person was a nurse, the law does not protect the title "doctor" in the same way.

This law does not it in its terms prevent any of these health professionals from titling themselves "doctor", at least so long as they state the type of health practitioner they are.

Some of the health and related professions on this list are quite scientifically oriented. Others are not. The mere fact that one is scientific ought not, in my opinion, entitle the use of the title "doctor" unless you are qualified as a medical practitioner or hold a doctorate awarded by a recognised university.  No doubt there are members of all of the above professions who hold doctorates. Most do not. Those that don't should not use the title "doctor" unless they are a medical doctor.Why should this exception apply only to medical practitioners (ie only to doctors)? Because that is what the word "doctor" means by its ordinary accepted usage.

What does "doctor" mean? The Macquarie Dictionary (Sydney, 1981) has this definition:
n 1. a person licensed to practise medicine, or some  branch of medicine; a physician or medical practitioner other than a surgeon. 2. a person who has received the highest degree conferred by a faculty of a university. a conventional title of respect of such  a person....a man [sic] of great learning...
Surprisingly, the Australian medical profession appears to have been slow to protect the title of doctor. In its joint submission (along with other Australian medical bodies) on the exposure draft of the national law, the AMA did not take up the issue of when could someone use the titles "doctor", "physician" or "surgeon". Their only concern appeared to me to be distinguishing medical doctors from PhDs.  (This is redolent of what one hears about medical doctors being concerned about status in clinical case conferences and ensuring everyone knows if a person has a doctorate instead of a medical degree).

Chiropractors have been quick out of the gates and frankly quite brazen in their approach. They have not changed their level of training or qualifications one bit, but they have issued a statement that they will amend the register of Chiropractors to officially call all their practitioners with the title "Doctor".  The Chiropractic Board of Australia has issued chiropractic advertising guidelines which advise chiropractors that they can use  the title doctor so long as they
 " make it clear that they do not  hold registration as medical practitioners; for example, by
including a reference to their health profession whenever
the title is used, such as:... Dr Walter Lin (Chiropractor)."
How this makes it clear that the person using the title doctor is not a medical practitioner is beyond me. An uninformed but intelligent layperson may well assume that the person is a medical practitioner who also has qualifications in chiropractic therapy; just as there are many medical practitioners who also have qualifications in acupuncture, Chinese medicine or otherwise regard themselves as "integrative".

Frankly, in my opinion there is nothing in the advertising guidelines of the Chiropractic Board that protects the public from advertising that is misleading and deceptive. There must have been a heated subterranean debate within the 14 national boards that (are soon to) make up the Australian Health Practitioners Regulation Agency about these guidelines - because the Psychologists (to their credit) disagree with the Chiropractors. Astonishingly, this disagreement, evidenced by the reference to what psychologists are advised by their professional Board, is contained in the very next paragraph of the Chiropractors' guidelines:

The Psychology Board of Australia has developed
specific advice for its profession. It advises registered
psychologists that use of the title ‘doctor’ in their
practice has the potential to mislead members of the
public. Specifically, patients or clients may be misled
into believing that the practitioner is a psychiatrist when
they are not. Therefore, registered psychologists may not
use such a title unless they hold a doctoral qualification....
Where a registered psychologist holds
a doctoral qualification that meets the above standard,
if they advertise their services to the public, they should
make it clear when using the title ‘doctor’ that they are
not a registered medical practitioner or psychiatrist, for
• Dr Vanessa Singh (Psychologist)

In other words, chiropractors acknowledge that it may be misleading for a psychologist to call themselves doctors, even if they hold a doctoral degree (if they don't also specify it is not a medical doctorate), but it is not misleading for a chiropractor who does not hold any qualification generally understood to be that of a doctor to do so. Incredible.

And what's more, the guidelines don't even try to construct an argument about why they should now suddenly be regarded as doctors. They just say, in effect, "we're free to do it, come aboard". The Australian Chiropractor's Association regard "doctor" as a "courtesy title"  that apparently ought to be available to any health professional who has done 5 years' study, whether of medicine or otherwise. They argue that because dentists and vets have begun to use the title "doctor" this should be extended further.

But, there is nothing in the new health practitioners law that limits the use of the term doctor to those with 5 year's study.There is nothing in the law  that limits who can use of the term "doctor" (or for that matter "physician" or "surgeon") at all. If chiropractors and osteopaths are doing it, soon it may be podiatrists, Chinese medicine practitioners, acupuncturists, pharmacists, nurses and midwives.

Some of these professional groups seem more restrained in claiming to be doctors than others.

The Chiropractic Board is also right to draw its members' attention to the Trade Practices Act (now replaced by the Competition and Consumer Act 2010), although they seem to suggest that following their guidelines will comply with the Act. I wonder if this is so. I am not a trade practices lawyer, but I wonder if this kind of behaviour is not prohibited by any number of provisions under the Australian Consumer Law.

Why does any of this matter? Because people may be deceived. Because they may be denied medical care on the false assumption that they are seeing a doctor and that the doctor will have in mind anything really medically serious they need to attend to. Because there is a mounting death toll from people who have used alternative medicine instead of medicine. And because the use of the term "doctor" in relation to people who are not is untrue.

The Australian Competition and Consumer Commission did a great job in cracking down on the bogus Power Balance bracelets.  Now's the time for them to find the right case to run against the misleading use of the term "doctor".