by hilzoy
From the WaPo:
“A new vaccine that protects against cervical cancer has set up a clash between health advocates who want to use the shots aggressively to prevent thousands of malignancies and social conservatives who say immunizing teenagers could encourage sexual activity. Although the vaccine will not become available until next year at the earliest, activists on both sides have begun maneuvering to influence how widely the immunizations will be employed.
Groups working to reduce the toll of the cancer are eagerly awaiting the vaccine and want it to become part of the standard roster of shots that children, especially girls, receive just before puberty. Because the vaccine protects against a sexually transmitted virus, many conservatives oppose making it mandatory, citing fears that it could send a subtle message condoning sexual activity before marriage. Several leading groups that promote abstinence are meeting this week to formulate official policies on the vaccine. (…)
The vaccine protects women against strains of a ubiquitous germ called the human papilloma virus. Although many strains of the virus are innocuous, some can cause cancerous lesions on the cervix (the outer end of the uterus), making them the primary cause of this cancer in the United States. Cervical cancer strikes more than 10,000 U.S. women each year, killing more than 3,700. The vaccine appears to be virtually 100 percent effective against two of the most common cancer-causing HPV strains. Merck, whose vaccine is further along, plans to ask the Food and Drug Administration by the end of the year for approval to sell the shots.
Exactly how the vaccine is used, however, will be largely determined by the Advisory Committee on Immunization Practices, a panel of experts assembled by the Centers for Disease Control and Prevention in Atlanta. The panel issues widely followed guidelines, including recommendations for childhood vaccines that become the basis for vaccination requirements set by public schools. Officials of both companies noted that research indicates the best age to vaccinate would be just before puberty to make sure children are protected before they become sexually active. The vaccine would probably be targeted primarily at girls but could also be used on boys to limit the spread of the virus. (…)
Conservative groups say they welcome the vaccine as an important public health tool but oppose making it mandatory. “Some people have raised the issue of whether this vaccine may be sending an overall message to teenagers that, ‘We expect you to be sexually active,’ ” said Reginald Finger, a doctor trained in public health who served as a medical analyst for Focus on the Family before being appointed to the ACIP in 2003, in a telephone interview.
“There are people who sense that it could cause people to feel like sexual behaviors are safer if they are vaccinated and may lead to more sexual behavior because they feel safe,” said Finger, emphasizing that he does not endorse that position and is withholding judgment until the issue comes before the vaccine policy panel for a formal recommendation.
Conservative medical groups have been fielding calls from concerned parents and organizations, officials said. “I’ve talked to some who have said, ‘This is going to sabotage our abstinence message,’ ” said Gene Rudd, associate executive director of the Christian Medical and Dental Associations. But Rudd said most people change their minds once they learn more, adding that he would probably want his children immunized. Rudd, however, draws the line at making the vaccine mandatory.
“Parents should have the choice. There are those who would say, ‘We can provide a better, healthier alternative than the vaccine, and that is to teach abstinence,’ ” Rudd said.”
Opposing this vaccine on the grounds that it might promote sexual activity is one of the stupidest things I’ve heard recently (and that’s saying a lot.) We are talking about a vaccine that is 100% effective against the two most dangerous strains of a virus that causes about 10,370 cases of invasive cervical cancer each year, of which about 3,710 are fatal. Those two strains cause about 70% of cases of cervical cancer. That means that every year this vaccine could prevent around 2,597 women from dying, and around 4,900 other women from having to go through the agony of being diagnosed with, and treated for, a serious form of cancer. And yet, for some reason, groups that call themselves “pro-life” oppose this vaccine because they think it will encourage sexual activity. Here’s a doctor quoted in a Focus on the Family newsletter:
“We’re going to be sending a message to a lot of kids that you just take this shot and you can be as sexually promiscuous as you want and it’s not going to be a problem,” he said. “That’s just not true.”
This is nonsense. How many teenagers would decide to start having sex if only they could be assured that while they are still at risk of getting pregnant or developing AIDS, gonorrhea, syphilis, chlamydia, genital warts, and so on, they would not develop cervical cancer? (Yes, I know that the virus that causes genital warts is the same one that causes cervical cancer. Like I said, the vaccine only protects against the two strains most likely to lead to cancer.) Somehow, I do not recall cervical cancer playing any role whatsoever in my own thinking on this topic, and in this one respect I do not think I’m all that unusual.
Moreover, it’s not as though abstinence education could protect women from getting the human papilloma virus, even if it succeeded in convincing teenagers to refrain from sex until marriage 100% of the time. According to Pia de Solenni, director of life and women’s issues for the Family Research Council,
“The situation they are trying to remedy with the vaccine is one that ultimately requires some type of behavior modification,” said de Solenni. “Abstinence until marriage and fidelity in marriage.”
— Wrong. No amount of abstinence education can protect women from rape; and no amount of fidelity to her husband will protect a woman if her husband has, unbeknownst to her, contracted the virus. And you can get the virus just as surely from being raped by, or married to, a man who carries the virus as you can by having Wild Promiscuous Sex. Lowering your number of sexual partners lowers the odds, but it does not lower them to zero.
To their credit, some conservative Christian groups (like the Christian Coalition of America) support the vaccine. I suspect that what’s going on with the others is something like this: many abstinence organizations stress the health benefits of abstinence. The human papilloma virus plays a significant role in the litanies of the horrors that attend sex, since it has several useful traits. Not only does it cause cancer; it is incredibly widespread; and, best of all, condoms do not fully protect against it, even leaving condom failure out of the picture. (It’s transmitted by skin-to-skin contact with an infected area, and not all the areas that can be infected are, um, covered by condoms.) So if you look at web pages promoting abstinence education (some are here, here, here, and here), the human papilloma virus gets a fair amount of play. If it ceased to be a danger, the case that sex with condoms was a reasonably (if not perfectly) safe alternative to abstinence would be a lot stronger, and abstinence advocates would no longer get to use the threat of cancer to dissuade people from having sex.
Plainly, though, abstinence advocates are not motivated by a desire to protect girls from developing cancer later in life. (If they were, they would welcome this vaccine, fold up their tents, and steal away into the night.) They should make their case on its merits. And they should certainly not work against a vaccine that can save thousands of lives each year just so that they can keep on using cancer to scare teenagers away from having sex.
“Opposing this vaccine on the grounds that it might promote sexual activity is one of the stupidest things I’ve heard recently (and that’s saying a lot.)”
Way beyond that, I’d say. Beyond offensive, and deep, deep, into nauseating. Beyond.
“We want to keep you from having sex, and it’s so important, we’d rather you have cancerous lesions on the cervix.”
That is, in fact, outright murderous.
I put it here, but it’s pretty much a re-wording of what I just said.
Amen, Gary. It’s obscene. Isn’t “reckless disregard” the legal term?
This is only the latest in a long line of issues that demonstrate beyond a shadow of a doubt that the so-called “culture of life” is a farce–a frame so self-evidently dishonest and hypocritical that it amazes me how otherwise intelligent and honest people can say it with a straight face.
Like so many other “culture of life” positions, this one has nothing to do with the sanctity of life and everything to do with dictating the sexual activity of consenting adults and controlling women based on a narrow, medieval and thoroughly sick approach to human sexuality.
This will serve as a useful litmus test for separating the conservative Christians who are sincerely pro-life from the ones who mouth the slogan, but actually fit the liberal stereotype of misogynist Taliban-like figures who are really more concerned with social control.
That aside, I doubt the pro-cancer position will gain much traction with most Americans, whatever their religious beliefs.
I make the distinction there in part because I have a fair number of conservative Christian friends and I think I’m safe in saying that none of them would take such a Taliban-like position.
This doctor that’s quoted is the head of Physician’s Consortium, whose effective goals are nearly diametrically opposed to their stated goals. By inspection, of course; have a look around.
And this just in: Dr. Hal Wallis has been beaten nearly to death by the stupid stick.
hilzoy, for someone who was for a time a committed Christian you don’t know your NT very well:
“And early in the morning He came again into the Temple, and all the people came unto Him; and He sat down, and taught them.”
“And the scribes and Pharisees brought unto Him a woman taken in adultery; and when they had set her in the midst, They say unto Him, Master, this woman was taken in adultery, in the very act. Now Moses in the Law commanded us, that such should be stoned: but what sayest Thou?”
“This they said, tempting Him, that they might have to accuse Him.”
“But Jesus stooped down, and with His finger wrote on the ground, as though He heard them not. So when they continued asking Him, He lifted up Himself, and said unto them, He that is without sin among you, let him first cast a stone at her. And again He stooped down, and wrote on the ground.”
“And they which heard it, being convicted by their own conscience, went out one by one, beginning at the eldest, even unto the last: and Jesus was left alone, and the woman standing in the midst.”
“When Jesus had lifted up Himself, and saw none but the woman, He said unto her, Woman, where are those thine accusers? Hath no man condemned thee?”
“She said, No man, Lord.”
“And Jesus said unto her, Neither do I condemn thee: go, and sin no more. Oh, and another thing, I hope you get cancer.” (John 8:2-11 KJV)
To their credit, some conservative Christian groups (like the Christian Coalition of America) support the vaccine.
As do I. And the originators and primary promulgators of the “culture of life” meme, the Catholics, to my knowledge, agree with me.
Which is to say, attack the opponents of the vaccine as you prefer — and often — but please don’t use this as a reason to deride the concept or the phrase.
Plainly, though, abstinence advocates are not motivated by a desire to protect girls from developing cancer later in life.
I’d say that’s painting with a pretty broad brush. There might be people around that have a 15 year old daughter that they truly want to be abstinent and also have a wife who has the pre-cancerous lesions. And those people might exist in a literal rather than a metaphorical way.
“And Jesus said unto her, Neither do I condemn thee: go, and sin no more. Oh, and another thing, I hope you get cancer.” (John 8:2-11 KJV)
Oh, I get it. That’s a joke, right?
And this just in: Dr. Hal Wallis has been beaten nearly to death by the stupid stick.
It’s astonishing how often the word “nearly” gets used in that context, although perhaps not as often as it probably shouldn’t.
And the originators and primary promulgators of the “culture of life” meme, the Catholics, to my knowledge, agree with me.
Which is to say, attack the opponents of the vaccine as you prefer — and often — but please don’t use this as a reason to deride the concept or the phrase.
George W. Bush uses the phrase all the time, while prosecuting a war that the Pope (the previous one, anyway) opposed, presumably because consistency in a “culture of life” position means doing everything you can not to kill innocent civilians — an inevitable consequence of a war. He uses it while vigorously supporting the death penalty.
I’d think you’d agree, tacitus that hilzoy’s use of the phrase is less offensive.
Understand, I don’t mean this as an attack. Your Catholicism is central to your life. It must bother you when the administration uses the phrase politically, without truly acting on it.
I did pause at that, Anarch, but I considered that a live stupid person can commit a lot more active stupidity than, for example, a dead stupid person could.
And those people might exist in a literal rather than a metaphorical way.
If they might exist, then I expect it’s more the latter than the former.
Isn’t the phrase “They might vaccinate their daughter against cervical cancer, if they didn’t want her to be abstinate” a form of the biscuit conditional?
*abstinent* obvs
Which is to say, attack the opponents of the vaccine as you prefer — and often — but please don’t use this as a reason to deride the concept or the phrase.
But it is exactly the opponents of the vaccine whose use of the phrase makes it worthy of derision. If you want the idea to be treated thoughtfully, maybe you should direct your criticism to the organizations and people who have made a joke of something you take seriously.
“There are people who sense that it could cause people to feel like sexual behaviors are safer if they are vaccinated and may lead to more sexual behavior because they feel safe,” said Finger, emphasizing that he does not endorse that position
…
But Rudd said most people change their minds once they learn more, adding that he would probably want his children immunized.
I really doubt that many people are “pro-cancer”.
If they might exist, then I expect it’s more the latter than the former.
Well I would be one of the former. I guess I didn’t make that very clear.
And although genital warts make pap smears much more interesting, they by no means guarantee that a full blown cancer will occur. So we’re not really freaking out about or any thing. I don’t know how this plays in the “pre-existing conditions” clauses of health insurance coverage, I guess I can put that in my list of things to worry about related to middle-age job uncertainty. How then am I not up in arms in favor of universal government run health care instead of privately run medical services and insurance? I guess some people are funny that way, and think that a monolithic health care system is more likely to have a catastrophic failure than a bunch of smaller competing hospitals and insurors. I’m in favor of the vaccine, by the way.
DaveC: I guess some people are funny that way, and think that a monolithic health care system is more likely to have a catastrophic failure than a bunch of smaller competing hospitals and insurors.
Not borne out by any actual evidence, of course, but there you go: who needs evidence when you have faith that unbridled capitalism is the right way to run a health care system? That’s how the US ended up with the most expensive health care system in the world… which is also the least effective health care system of any industrialized country.
who needs evidence when you have faith that unbridled capitalism is the right way to run a health care system?
I’ll concede that US health care is expensive, but will note that the profit motive drives many improvements in health care techniques. But I do R&D work in a medical diagnostic field, and that might explain why I feel that way.
“And they should certainly not work against a vaccine that can save thousands of lives each year just so that they can keep on using cancer to scare teenagers away from having sex.”
Just to be perfectly clear about this:
And they should certainly not work against a vaccine that can save thousands of lives each year just so that they can keep on using cancer UNSUCCESSFULLY to scare teenagers away from having sex.
This is “unbridled capitalism”? Funny, that; looks to me like that horse is heavily harnessed.
Barry: I’ll concede that US health care is expensive, but will note that the profit motive drives many improvements in health care techniques.
But rarely any new medical discoveries: and certainly not any impetus to make sure that everyone stays as healthy as possible. The cutting-edge health care techniques, which are not in any case available to the 40% with no health insurance, are not how WHO measures how good a nation’s health care system is.
Jesurgislac, that was DaveC, not me.
The cutting-edge health care techniques, which are not in any case available to the 40% with no health insurance, are not how WHO measures how good a nation’s health care system is.
Surely these techniques, and their availability, ought to be a part of the measure, WHO notwithstanding.
The American health care system is an example of “unbridled capitalism”? Hoo boy. It’s as if Medicare Part D never happened. One can dream.
Your Catholicism is central to your life.
Actually, I’m an apostate from Catholicism. I still admire the faith, though.
….it is exactly the opponents of the vaccine whose use of the phrase makes it worthy of derision.
Only if you think they are its primary promulgators, and/or its originators, and/or that their advocacy on this point morally or pragmatically outstrips all else directed toward that phrase’s end. Which you may; but you’d be wrong on all counts.
“But Jesus stooped down, and with His finger wrote on the ground.”
This is one of the most fascinating passages in the Bible to me. What did Jesus write? Is there something sufficiently profound (modulo the fundamental string equation) for a fragment of G*d to write? “If not now, when?” Did no one come by and read the Truth written in the dust and chisel it into a slab of marble? And was it effaced by the wind or a footprint, or is still there if you look in the right place?
And how could xians have lynched fellow humans beings having read this? Has anyone since tried the above procedure on a mob? Is the story meant to be read as an actual occurence in the loaves-and-fishes category?
The Pharisees thought that they were fishing for Jesus but they didn’t realize where the hook actually was.
I also like that the woman recognizes Jesus for what he is and calls him “Lord” – I think that’s internal evidence for l-and-f. Anyone able to make human life make sense to a mob and to its victim can’t be human.
I guess the stick hadn’t been invented yet, rilkefan.
There’s lightning in Florida, right?
One of my favorite moments in Gene Wolfe’s _Torturer_ sequence is when Severian realizes that the grains of sand of the beach he is standing on fell from the hands of the Increate; he throws his boots in the sea, not wanting to walk shod on holy ground.
Surely these techniques, and their availability, ought to be a part of the measure, WHO notwithstanding.
This site explains the indicators and indices used.
The simplified explanation of the performance of a health care system:
One reason why the US rates so poorly is because it spends so much on healthcare, yet so many people have restricted access or no access to the healthcare being paid for.
Similarly egregious: Drum on “spousal” notification.
The American health care system is an example of “unbridled capitalism”? Hoo boy. It’s as if Medicare Part D never happened.
Why even bring in Medicare — the commercial health care itself is so heavily regulated as to be barely distinguishable from government-run health care.
And note that while part D is (partially)government-funded, it’s private HMOs that are actually supplying the benefit, and (in principle anyway) competition between them will hold down costs.
Maybe this is a stupid analogy, but do you think that dining out would be better if all restaurants were government institutions and that all would charge equally regardless of the quality of the food? There are so many people who hate McDonalds. Do you think it would be better if the quality was raised somewhat and all restaurants became a state-run Denny’s franchise, but no other competing restaurants were allowed because their prices may be higher?
DaveC: Maybe this is a stupid analogy, but do you think that dining out would be better if all restaurants were government institutions and that all would charge equally regardless of the quality of the food?
Well, yes, it is a stupid analogy. (Sorry.) A better analogy would be to argue that a monolithic military is more likely to have a catastrophic failure than a bunch of smaller competing armies and intelligence services. People should be able to decide which part of the US military they want to defend their home, and they shouldn’t have to pay for the bits they don’t need. They ought to be able to choose and decide, because the free market is always best, right? Why should the whole of the US military be run from the Pentagon? Why shouldn’t there be competing privatized militaries? Isn’t it favoritism to have the President be Commander in Chief?
If I don’t want to cook dinner tonight, I can decide to walk a mile to a good pizza house, or catch a bus uptown to the best Indian restaurant in the world, or even phone up and get food delivered. There are multiple options, and I am well-qualified to decide for myself which one will best suit me, flavor, cuisine, and price.
If I break my leg, I do not, in fact, want to be presented with a menu of options: I want the ambulance to take me to the nearest hospital where they can set my leg. If I have to go for an operation, I don’t want to have to try and figure out ahead of time which surgeon I think is best, what anaesthetic they should use, what hospital I want it done in.
If you think monolithic government operations are intrinsically a bad thing, why not campaign for a decentralised, entirely profit-making US military? It would probably have meant the invasion of Iraq never happened, if the Bush administration had had to convince multiple CEOs of private armies that this would be a sufficiently profitable operation to make it worth their while. But think of the military innovations that might result!
Lightning death capital of at least THIS half of the world, rilkefan. I’ve heard there are places in the Eastern Hemisphere that are worse, but I don’t know how solid the data are.
Seems drastic to me; I think I’d just tuck them under an arm. I haven’t read Wolfe in a long time; the Torturer series (or whatever it’s called) was, for me, difficult to stay with. Maybe now, a couple of decades later in life, I’ll enjoy it more.
Here’s a real life personal example, not necessarily having to do with government. My wife was having really bad back pain. Her GP, who is good in very many respects, thought it was arthritis and that nothing much could be done. Her chiropracter read the Xrays and spotted a cyst inside of her spine, and referred her to a neurologist who did a 2 hour, minimally invasive surgery with a 1.5 inch incision to get rid of the cyst; and that did effectively cure her problem.
Now I’m not generally a big believer in chiropracters, but this lady was a very very good diagnostician, and made the right call when she saw that surgery was the way to go. The lesson here that it is a good idea to get second opinions.
I’ll try to work up some non-stupid analogies in the future 🙂 Currently I’m thinking about how the milkman used to leave milk at the door (way back when!), and how now I drive to the gas station (er, petrol) in order to get milk. I don’t know what this all means, but will find a way to insert it into a comment.
DaveC, I do apologise for saying it was a stupid analogy. My only defense is that you said it first… 🙂
Now I’m not generally a big believer in chiropracters, but this lady was a very very good diagnostician, and made the right call when she saw that surgery was the way to go. The lesson here that it is a good idea to get second opinions.
I’d agree with that.
Well, then, Slart, I wouldn’t go waving a stick in a storm if I were you.
The first time I read _The Shadow of the Torturer_ I was too young – I was so horrified by it that I did my best to forget ever having read it. Later I rediscovered Wolfe and found the book and sequence to be marvelous. I’ve kind of gone off his recent work though.
“Maybe this is a stupid analogy, but do you think that dining out would be better if all restaurants were government institutions and that all would charge equally regardless of the quality of the food?”
The part this analogy fails in is finding people who want all doctors to be government institutions/employees and forcing them to all charge equally. But other than that, you’re onto something.
“I don’t want to have to try and figure out ahead of time which surgeon I think is best,”
On the other hand, in that case, you’re giving up a lot of control, unless you believe that doctors are fungible and all equivalent. Iatragenic illness or damage doesn’t actually discriminate by whose name is on the paycheck. If you’re not checking stats and credentials of your doctor, well, that certainly displays touching faith in Authority.
“If you’re not checking stats”
If you’re believing raw stats, you might need a different sort of doc.
“iatrogenic”. “Doctor-caused”. Maybe “iatragenic” means “caused by a female doctor” – I have no Greek.
Now I’m not generally a big believer in chiropracters, but this lady was a very very good diagnostician, and made the right call when she saw that surgery was the way to go. The lesson here that it is a good idea to get second opinions.
I agree. But wouldn’t that be an argument IN FAVOR of a governmental health insurance system where second opinions are free? That way more people would be able to get them…