My mom thinks me using facts is racist. Poor people tend to be black. Poor people tend to commit crimes. White people tend to move away from black neighborhoods. I suppose I should have spent less time studying political behavior in my state and more time making jokes.

"What's the difference between a black man and a white man?" "A job." - From the woman who calls me a racist for saying most violent crime in the US is black on black crime.

The biggest issue with the mainstream and statistics is that unless it plays into their stereotypes of behavior, they don't care. And when it does, they don't really care about the real cause.

From Wiki: (Violent Crime, UK)

"Includes all violence against the person, sexual offences, and robbery as violent crime.[8]
Rates of violent crime are in the UK are recorded by the British Crime Survey. The Home Office Statistical Bulletin on "Crime in England and Wales" summarizes the findings of this survey. For the 2010/2011 report,[9] the statistics show that violent crime continues a general downward trend observed over the last few decades as shown in the graph.
"The 2010/11 BCS showed overall violence was down 47 per cent on the level seen at its peak in 1995; representing nearly two million fewer violent offences per year."[citation needed]
Regarding murder, "increasing levels of homicide (at around 2% to 3% per year) [have been observed] from the 1960s through to the end of the twentieth century". Recently the murder rate has declined, "a fall of 19 per cent in homicides since 2001/02", as measured by The Homicide Index.
By contrast, there is a widespread belief that violent crime is on the rise, due largely to a mass media which disproportionately reports violent crime. This phenomenon is described by Steven Pinker in The Better Angels of Our Nature."

(Violent Crime, US)

"The United States Department of Justice Bureau of Justice Statistics (BJS) counts five categories of crime as violent crimes: murder, forcible rape, robbery, aggravated assault, and simple assault. It should be noted that these crimes are taken from two separate reports, the Uniform Crime Report (UCR) and the National Crime Victimization Survey (NCVS), and that these do not look at exactly the same crimes. The UCR measures crimes reported to police, and looks at Aggravated assault, forcible rape, murder, and robbery. The NCVS measures crimes reported by households surveyed by the United States Census Bureau, and looks at assault, rape, and robbery. According to BJS figures, the rate of violent crime victimization in the United States declined by more than two thirds between the years 1994 and 2009.[10] 7.9% of sentenced prisoners in federal prisons on September 30, 2009 were in for violent crimes.[11] 52.4% of sentenced prisoners in state prisons at yearend 2008 were in for violent crimes.[11] 21.6% of convicted inmates in jails in 2002 (latest available data by type of offense) were in for violent crimes.[12]"



------------------------

If you didn't want to read that babble, quick and simple: they're one and the same. From my understanding, both countries use the Type 1 list: a crime against a person in which injury or death may occur. In some cases, just because no one was hurt, doesn't mean it wasn't a violent crime.

Which brings up the other point to be made. Is the reporting of the crimes uniform? Do the Brits report EVERYTHING, as opposed to what's somewhat routine here in the states where crimes often go unreported, even when the police show up? Domestic violence only exists if one person files charges. The victim could be bruised, bleeding, broken bones etc, but if they're not willing to file a charge, no crime occurred.

Or, more so, do street brawls get reported more often in the UK? If I punch some dude, does that go onto a record somewhere where as in the states, I've been in many fights where even if the police broke it up, no reports were ever filed.

All of this is useful information, but so far the data is pretty superficial. The comment the video makes about "put on your boots and go find out" (paraphrased) is pretty much the only solution I can think of. Then again, it's the same solution that people have been chanting for for generations and have yet to see the high and mighty Elite do it.

It's not that there is a 'war' on... it's that there are a bunch of non-scientists walking around saying they're 'creation scientists'.

Many creation scientists have advanced degrees and have published many papers. Why aren't they scientists? What makes a scientist a scientist?

You're absolutely correct, there is no research being done on 'young Universe'... but there is also no science being done to prove 'old Universe'. Science is done by taking small bits of knowledge that have little gaps, and filling those gaps in. We didn't figure out the half-life of Rubidium in order to prove the age of the earth, we figured out the half-life of Rubidium to figure out the half-life of Rubidium. Some other scientists had taken measurements of the natural occurrence of elements and their isotopes in various parts of the world. And then more scientists apply the knowledge acquired in both fields and try to find out what it tells us.

There was a very concerted effort, especially during the 19th and 20th centuries to come up with evidence for an old age of the Earth to support the ideas of uniformitarian geology and macro evolution. There was an ideological war going on, just as there is today, between those secular scientists who wanted to establish their own secular idea of origins to undercut the account of biblical creation. Up until that point, all geologists were flood geologists. Now a days, you're right, they are resting on their laurels, because as I said it has become conventional wisdom, which is not science but philosophy.

I agree, you absolutely should question scientists with an agenda, but I've NEVER heard a non-christian suggest that there is scientific evidence for the earth being younger than 4-5 billion years old.

I grew up in a secular home with a great love for science, and I very activiely pursued studies in astronomy and biology. In all of my studies, I never heard so much as a peep about the controversy. There is an information filter on this subject, and it had kept me in the dark about the whole thing most of my life.

You want to cast doubt on scientists by saying that there are millions of dollars and reputations on the line, but this reasoning is more destructive if you aim it at the young-earthers: Their religion has made explicit claims as to time-spans that occurred 'in the beginning'... their religious leaders have made explicit claims as to the literalness of the Bible. And most church leaders have been explicit that other denominations of Christians may not be allowed into heaven... So you have a large group of individuals who are not only risking their reputation, but what they believe is their eternal soul, on something that they didn't discover, but have worked backward to find evidence to prove that their book is correct.

None of this has anything to do with the question of salvation. The conflict you're seeing is coming from a liberal movement within the church which tends to embrace secular values and rejects traditional interpretation of scripture. As numbers go, it is a small amount of people. As a recent survey shows, the majority of Americans (ie 46 percent) believe in creationism:

http://www.huffingtonpost.com/2012/06/05/americans-believe-in-creationism_n_1571127.html

These views get overreprented in the media by liberals sympathic to their causes. It gets presented in such a way that it looks like it is the majority view when it is actually the minority view.

As far as what Creation scientists have to lose..not much. They already lost much of what they had to lose by becoming a creation scientist in the first place.

Young-earthers each, individually, have much more to lose than scientists. And let's be clear... religions have enough money to staff up scientific R&D labs and fund their own research if they wanted. In fact, the Vatican DOES have it's own, world-renowned observatory. So, how old does this Priest thing the Universe is?
http://www.youtube.com/watch?feature=player_embedded&v=OwWqrXGtrRs#!

I don't agree with the catholic church on practically anything, let alone this.

So, to be clear, it's not Scientists vs. Christians. It's Scientists AND Christians vs. People Who Don't Trust Science.

It's actually the wisdom of God versus the wisdom of man.

And I expect this. Christians have long fought against persecution, and it thrived while it was being persecuted. Now that it's the dominant religion, many of the teachings have lost their luster. Members who believe that the Bible has something personal to say to them will pick up on the persecution aspect, which was intended to help those in the year 200AD... not 2012. So they make up bogey-men and pick a fight with anyone who says something that isn't explicitly allowed in the Bible (and is convenient for them)... hence the anti-Gay-Marriage protests, but no anti-shellfish protests.

Over 200 thousand Christians are martyred every year for their faith, all over the world.

You're a product of your environment, shinyblurry... you're as predictable as Islam producing suicide bombers... and just as pathetic in your misunderstanding of the Universe.

All I'll say to this is that ad hominem attacks reveal more about your character than they do mine.

Doing a simple calculation of the area of a disk 10,000 light-years vs. 100,000 light-years (but 50,000 light-years in radius) yields an area of our galaxy about 25 times larger that we can NOT survey for supernova remnants vs. what we can.

That's incorrect. We have radio telescope images of the galactic center which is 26000 light years away. Second, the estimates are based not on what we can't see, but the percentage that we can see and then averaging for the rest.

The next part is that supernova remnants don’t just form out of nothing, they form from the explosions of dying stars. The stars that live and die the fastest still take about 10,000,000 years before they “go nova” and release a cloud of debris that will later become what we observe. That’s pretty much the minimum time a star can “live” during the current epoch of the Universe. Only after that will we see a supernova form.

Actually, O3 type stars can go nova in about 3 million years time, according to that model.

So, add that to our estimate of the age by the number of stars and we have 10,250,000 years, or 10.25 million years for the age of the galaxy. You should note at this point I’ve been saying “age of the galaxy.” That’s because this would only be used to date our galaxy, not the Universe as a whole. So you need to add in the time for galaxy formation … which is still a number that’s hotly debated, but no respected astronomer will say happens instantaneously.

You can't argue that the galaxy is that old because the stars are that old, when that is the thing in dispute. The argument is intending to prove the stars couldn't be that old in the first place, thus proving the galaxy is not that old.

BUT, there’s another complication to this situation which shows why this apparent “method” for dating our galaxy isn’t valid: Supernova remnants fade! They only are visible for a few tens of thousands of years. What does this mean for our estimate of 1,000,000 years for the age of our galaxy? Well, by the time the “oldest” supernova is fading, we starting to observe supernova 200! We should only expect to see in the neighborhood of a few hundred supernova remnants in our vicinity, regardless of how old our galaxy actually is."

According to

http://www.talkorigins.org/faqs/supernova/snrfab.html

"Obviously, Davies never went SNR hunting in a galactic environment, but I have. For one thing, an SNR becomes essentially invisible, even in a non-crowded environment, within 1,000,000 year tops, maybe less, depending on the specifics of the supernova and environment. But in practice they become essentially invisible long before."

So, they can be visible up to 1,000,000 years, yet we don't find even one at the maximum range of expansion that we are able to detect (or anywhere near it). We should be seeing the entire range of the spectrum, but the biggest we can find (according to their model), is 20000 years old. So this evidence doesn't hold up and the point remains.

Old hat.

"We cannot observe supernova remnants across our entire galaxy – basically nebulae. Supernova events we can see across the visible universe, but the actual gaseous remnants are much fainter because they are more diffuse. Because of dust and gas in the way, we cannot see all the objects in our own Galaxy. Probably the farthest we can see into the galaxy is maybe to a distance of 10,000 light-years. The galaxy is about 100,000 light-years across. Doing a simple calculation of the area of a disk 10,000 light-years vs. 100,000 light-years (but 50,000 light-years in radius) yields an area of our galaxy about 25 times larger that we can NOT survey for supernova remnants vs. what we can.

So now, we need to multiply our 10,000 years by 25, giving us 250,000 years for the age of the galaxy.

The next part is that supernova remnants don’t just form out of nothing, they form from the explosions of dying stars. The stars that live and die the fastest still take about 10,000,000 years before they “go nova” and release a cloud of debris that will later become what we observe. That’s pretty much the minimum time a star can “live” during the current epoch of the Universe. Only after that will we see a supernova form.

So, add that to our estimate of the age by the number of stars and we have 10,250,000 years, or 10.25 million years for the age of the galaxy. You should note at this point I’ve been saying “age of the galaxy.” That’s because this would only be used to date our galaxy, not the Universe as a whole. So you need to add in the time for galaxy formation … which is still a number that’s hotly debated, but no respected astronomer will say happens instantaneously.

BUT, there’s another complication to this situation which shows why this apparent “method” for dating our galaxy isn’t valid: Supernova remnants fade! They only are visible for a few tens of thousands of years. What does this mean for our estimate of 1,000,000 years for the age of our galaxy? Well, by the time the “oldest” supernova is fading, we starting to observe supernova 200! We should only expect to see in the neighborhood of a few hundred supernova remnants in our vicinity, regardless of how old our galaxy actually is."

http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=all

One October afternoon three years ago while I was visiting my parents, my mother made a request I dreaded and longed to fulfill. She had just poured me a cup of Earl Grey from her Japanese iron teapot, shaped like a little pumpkin; outside, two cardinals splashed in the birdbath in the weak Connecticut sunlight. Her white hair was gathered at the nape of her neck, and her voice was low. “Please help me get Jeff’s pacemaker turned off,” she said, using my father’s first name. I nodded, and my heart knocked.
Related

Upstairs, my 85-year-old father, Jeffrey, a retired Wesleyan University professor who suffered from dementia, lay napping in what was once their shared bedroom. Sewn into a hump of skin and muscle below his right clavicle was the pacemaker that helped his heart outlive his brain. The size of a pocket watch, it had kept his heart beating rhythmically for nearly five years. Its battery was expected to last five more.

After tea, I knew, my mother would help him from his narrow bed with its mattress encased in waterproof plastic. She would take him to the toilet, change his diaper and lead him tottering to the couch, where he would sit mutely for hours, pretending to read Joyce Carol Oates, the book falling in his lap as he stared out the window.

I don’t like describing what dementia did to my father — and indirectly to my mother — without telling you first that my parents loved each other, and I loved them. That my mother, Valerie, could stain a deck and sew an evening dress from a photo in Vogue and thought of my father as her best friend. That my father had never given up easily on anything.

Born in South Africa, he lost his left arm in World War II, but built floor-to-ceiling bookcases for our living room; earned a Ph.D. from Oxford; coached rugby; and with my two brothers as crew, sailed his beloved Rhodes 19 on Long Island Sound. When I was a child, he woke me, chortling, with his gloss on a verse from “The Rubaiyat of Omar Khayyam”: “Awake, my little one! Before life’s liquor in its cup be dry!” At bedtime he tucked me in, quoting “Hamlet” : “May flights of angels sing thee to thy rest!”

Now I would look at him and think of Anton Chekhov, who died of tuberculosis in 1904. “Whenever there is someone in a family who has long been ill, and hopelessly ill,” he wrote, “there come painful moments when all timidly, secretly, at the bottom of their hearts long for his death.” A century later, my mother and I had come to long for the machine in my father’s chest to fail.

Until 2001, my two brothers and I — all living in California — assumed that our parents would enjoy long, robust old ages capped by some brief, undefined final illness. Thanks to their own healthful habits and a panoply of medical advances — vaccines, antibiotics, airport defibrillators, 911 networks and the like — they weren’t likely to die prematurely of the pneumonias, influenzas and heart attacks that decimated previous generations. They walked every day. My mother practiced yoga. My father was writing a history of his birthplace, a small South African town.

In short, they were seemingly among the lucky ones for whom the American medical system, despite its fragmentation, inequity and waste, works quite well. Medicare and supplemental insurance paid for their specialists and their trusted Middletown internist, the lean, bespectacled Robert Fales, who, like them, was skeptical of medical overdoing. “I bonded with your parents, and you don’t bond with everybody,” he once told me. “It’s easier to understand someone if they just tell it like it is from their heart and their soul.”

They were also stoics and religious agnostics. They signed living wills and durable power-of-attorney documents for health care. My mother, who watched friends die slowly of cancer, had an underlined copy of the Hemlock Society’s “Final Exit” in her bookcase. Even so, I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.

Things took their first unexpected turn on Nov. 13, 2001, when my father — then 79, pacemakerless and seemingly healthy — collapsed on my parents’ kitchen floor in Middletown, making burbling sounds. He had suffered a stroke.

He came home six weeks later permanently incapable of completing a sentence. But as I’ve said, he didn’t give up easily, and he doggedly learned again how to fasten his belt; to peck out sentences on his computer; to walk alone, one foot dragging, to the university pool for water aerobics. He never again put on a shirt without help or looked at the book he had been writing. One day he haltingly told my mother, “I don’t know who I am anymore.”

His stroke devastated two lives. The day before, my mother was an upper-middle-class housewife who practiced calligraphy in her spare time. Afterward, she was one of tens of millions of people in America, most of them women, who help care for an older family member.

Their numbers grow each day. Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the “oldest old” have become the nation’s most rapidly growing age group. Nearly a third of Americans over 85 have dementia (a condition whose prevalence rises in direct relationship to longevity). Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast. Even though a capable woman was hired to give my dad showers, my 77-year-old mother found herself on duty more than 80 hours a week. Her blood pressure rose and her weight fell. On a routine visit to Dr. Fales, she burst into tears. She was put on sleeping pills and antidepressants.

My father said he came to believe that she would have been better off if he had died. “She’d have weeped the weep of a widow,” he told me in his garbled, poststroke speech, on a walk we took together in the fall of 2002. “And then she would have been all right.” It was hard to tell which of them was suffering more.

As we shuffled through the fallen leaves that day, I thought of my father’s father, Ernest Butler. He was 79 when he died in 1965, before pacemakers, implanted cardiac defibrillators, stents and replacement heart valves routinely staved off death among the very old. After completing some long-unfinished chairs, he cleaned his woodshop, had a heart attack and died two days later in a plain hospital bed. As I held my dad’s soft, mottled hand, I vainly wished him a similar merciful death.

A few days before Christmas that year, after a vigorous session of water exercises, my father developed a painful inguinal (intestinal) hernia. My mother took him to Fales, who sent them to a local surgeon, who sent them to a cardiologist for a preoperative clearance. After an electrocardiogram recorded my father’s slow heartbeat — a longstanding and symptomless condition not uncommon in the very old — the cardiologist, John Rogan, refused to clear my dad for surgery unless he received a pacemaker.

Without the device, Dr. Rogan told me later, my father could have died from cardiac arrest during surgery or perhaps within a few months. It was the second time Rogan had seen my father. The first time, about a year before, he recommended the device for the same slow heartbeat. That time, my then-competent and prestroke father expressed extreme reluctance, on the advice of Fales, who considered it overtreatment.

My father’s medical conservatism, I have since learned, is not unusual. According to an analysis by the Dartmouth Atlas medical-research group, patients are far more likely than their doctors to reject aggressive treatments when fully informed of pros, cons and alternatives — information, one study suggests, that nearly half of patients say they don’t get. And although many doctors assume that people want to extend their lives, many do not. In a 1997 study in The Journal of the American Geriatrics Society, 30 percent of seriously ill people surveyed in a hospital said they would “rather die” than live permanently in a nursing home. In a 2008 study in The Journal of the American College of Cardiology, 28 percent of patients with advanced heart failure said they would trade one day of excellent health for another two years in their current state.

When Rogan suggested the pacemaker for the second time, my father was too stroke-damaged to discuss, and perhaps even to weigh, his trade­offs. The decision fell to my mother — anxious to relieve my father’s pain, exhausted with caregiving, deferential to doctors and no expert on high-tech medicine. She said yes. One of the most important medical decisions of my father’s life was over in minutes. Dr. Fales was notified by fax.

Fales loved my parents, knew their suffering close at hand, continued to oppose a pacemaker and wasn’t alarmed by death. If he had had the chance to sit down with my parents, he could have explained that the pacemaker’s battery would last 10 years and asked whether my father wanted to live to be 89 in his nearly mute and dependent state. He could have discussed the option of using a temporary external pacemaker that, I later learned, could have seen my dad safely through surgery. But my mother never consulted Fales. And the system would have effectively penalized him if she had. Medicare would have paid him a standard office-visit rate of $54 for what would undoubtedly have been a long meeting — and nothing for phone calls to work out a plan with Rogan and the surgeon.

Medicare has made minor improvements since then, and in the House version of the health care reform bill debated last year, much better payments for such conversations were included. But after the provision was distorted as reimbursement for “death panels,” it was dropped. In my father’s case, there was only a brief informed-consent process, covering the boilerplate risks of minor surgery, handled by the general surgeon.

I believe that my father’s doctors did their best within a compartmentalized and time-pressured medical system. But in the absence of any other guiding hand, there is no doubt that economics helped shape the wider context in which doctors made decisions. Had we been at the Mayo Clinic — where doctors are salaried, medical records are electronically organized and care is coordinated by a single doctor — things might have turned out differently. But Middletown is part of the fee-for-service medical economy. Doctors peddle their wares on a piecework basis; communication among them is haphazard; thinking is often short term; nobody makes money when medical interventions are declined; and nobody is in charge except the marketplace.

And so on Jan. 2, 2003, at Middlesex Hospital, the surgeon implanted my father’s pacemaker using local anesthetic. Medicare paid him $461 and the hospital a flat fee of about $12,000, of which an estimated $7,500 went to St. Jude Medical, the maker of the device. The hernia was fixed a few days later.

It was a case study in what primary-care doctors have long bemoaned: that Medicare rewards doctors far better for doing procedures than for assessing whether they should be done at all. The incentives for overtreatment continue, said Dr. Ted Epperly, the board chairman of the American Academy of Family Physicians, because those who profit from them — specialists, hospitals, drug companies and the medical-device manufacturers — spend money lobbying Congress and the public to keep it that way.

Last year, doctors, hospitals, drug companies, medical-equipment manufacturers and other medical professionals spent $545 million on lobbying, according to the Center for Responsive Politics. This may help explain why researchers estimate that 20 to 30 percent of Medicare’s $510 billion budget goes for unnecessary tests and treatment. Why cost-containment received short shrift in health care reform. Why physicians like Fales net an average of $173,000 a year, while noninvasive cardiologists like Rogan net about $419,000.

The system rewarded nobody for saying “no” or even “wait” — not even my frugal, intelligent, Consumer-Reports-reading mother. Medicare and supplemental insurance covered almost every penny of my father’s pacemaker. My mother was given more government-mandated consumer information when she bought a new Camry a year later.

And so my father’s electronically managed heart — now requiring frequent monitoring, paid by Medicare — became part of the $24 billion worldwide cardiac-device industry and an indirect subsidizer of the fiscal health of American hospitals. The profit margins that manufacturers earn on cardiac devices is close to 30 percent. Cardiac procedures and diagnostics generate about 20 percent of hospital revenues and 30 percent of profits.

Shortly after New Year’s 2003, my mother belatedly called and told me about the operations, which went off without a hitch. She didn’t call earlier, she said, because she didn’t want to worry me. My heart sank, but I said nothing. It is one thing to silently hope that your beloved father’s heart might fail. It is another to actively abet his death.

The pacemaker bought my parents two years of limbo, two of purgatory and two of hell. At first they soldiered on, with my father no better and no worse. My mother reread Jon Kabat-Zinn’s “Full Catastrophe Living,” bought a self-help book on patience and rose each morning to meditate.

In 2005, the age-related degeneration that had slowed my father’s heart attacked his eyes, lungs, bladder and bowels. Clots as narrow as a single human hair lodged in tiny blood vessels in his brain, killing clusters of neurons by depriving them of oxygen. Long partly deaf, he began losing his sight to wet macular degeneration, requiring ocular injections that cost nearly $2,000 each. A few months later, he forgot his way home from the university pool. He grew incontinent. He was collapsing physically, like an ancient, shored-up house.

In the summer of 2006, he fell in the driveway and suffered a brain hemorrhage. Not long afterward, he spent a full weekend compulsively brushing and rebrushing his teeth. “The Jeff I married . . . is no longer the same person,” my mother wrote in the journal a social worker had suggested she keep. “My life is in ruins. This is horrible, and I have lasted for five years.” His pacemaker kept on ticking.

When bioethicists debate life-extending technologies, the effects on people like my mother rarely enter the calculus. But a 2007 Ohio State University study of the DNA of family caregivers of people with Alzheimer’s disease showed that the ends of their chromosomes, called telomeres, had degraded enough to reflect a four-to-eight-year shortening of lifespan. By that reckoning, every year that the pacemaker gave my irreparably damaged father took from my then-vigorous mother an equal year.

When my mother was upset, she meditated or cleaned house. When I was upset, I Googled. In 2006, I discovered that pacemakers could be deactivated without surgery. Nurses, doctors and even device salesmen had done so, usually at deathbeds. A white ceramic device, like a TV remote and shaped like the wands that children use to blow bubbles, could be placed around the hump on my father’s chest. Press a few buttons and the electrical pulses that ran down the leads to his heart would slow until they were no longer effective. My father’s heart, I learned, would probably not stop. It would just return to its old, slow rhythm. If he was lucky, he might suffer cardiac arrest and die within weeks, perhaps in his sleep. If he was unlucky, he might linger painfully for months while his lagging heart failed to suffuse his vital organs with sufficient oxygenated blood.

If we did nothing, his pacemaker would not stop for years. Like the tireless charmed brooms in Disney’s “Fantasia,” it would prompt my father’s heart to beat after he became too demented to speak, sit up or eat. It would keep his heart pulsing after he drew his last breath. If he was buried, it would send signals to his dead heart in the coffin. If he was cremated, it would have to be cut from his chest first, to prevent it from exploding and damaging the walls or hurting an attendant.

On the Internet, I discovered that the pacemaker — somewhat like the ventilator, defibrillator and feeding tube — was first an exotic, stopgap device, used to carry a handful of patients through a brief medical crisis. Then it morphed into a battery-powered, implantable and routine treatment. When Medicare approved the pacemaker for reimbursement in 1966, the market exploded. Today pacemakers are implanted annually in more than 400,000 Americans, about 80 percent of whom are over 65. According to calculations by the Dartmouth Atlas research group using Medicare data, nearly a fifth of new recipients who receive pacemakers annually — 76,000 — are over 80. The typical patient with a cardiac device today is an elderly person suffering from at least one other severe chronic illness.

Over the years, as technology has improved, the battery life of these devices lengthened. The list of heart conditions for which they are recommended has grown. In 1984, the treatment guidelines from the American College of Cardiology declared that pacemakers were strongly recommended as “indicated” or mildly approved as “reasonable” for 56 heart conditions and “not indicated” for 31 more. By 2008, the list for which they were strongly or mildly recommended expanded to 88, with most of the increase in the lukewarm “reasonable” category.

The research backing the expansion of diagnoses was weak. Over all, only 5 percent of the positive recommendations were supported by research from multiple double-blind randomized studies, the gold standard of evidence-based medicine. And 58 percent were based on no studies at all, only a “consensus of expert opinion.” Of the 17 cardiologists who wrote the 2008 guidelines, 11 received financing from cardiac-device makers or worked at institutions receiving it. Seven, due to the extent of their financial connections, were recused from voting on the guidelines they helped write.

This pattern — a paucity of scientific support and a plethora of industry connections — holds across almost all cardiac treatments, according to the cardiologist Pierluigi Tricoci of Duke University’s Clinical Research Institute. Last year in The Journal of the American Medical Association, Tricoci and his co-authors wrote that only 11 percent of 2,700 widely used cardiac-treatment guidelines were based on that gold standard. Most were based only on expert opinion.

Experts are as vulnerable to conflicts of interest as researchers are, the authors warned, because “expert clinicians are also those who are likely to receive honoraria, speakers bureau [fees], consulting fees or research support from industry.” They called the current cardiac-research agenda “strongly influenced by industry’s natural desire to introduce new products.”

Perhaps it’s no surprise that I also discovered others puzzling over cardiologists who recommended pacemakers for relatives with advanced dementia. “78-year-old mother-in-law has dementia; severe short-term memory issues,” read an Internet post by “soninlaw” on Elderhope.com, a caregivers’ site, in 2007. “On a routine trip to her cardiologist, doctor decides she needs a pacemaker. . . . Anyone have a similar encounter?”

By the summer of 2007, my dad had forgotten the purpose of a dinner napkin and had to be coached to remove his slippers before he tried to put on his shoes. After a lifetime of promoting my father’s health, my mother reversed course. On a routine visit, she asked Rogan to deactivate the pacemaker. “It was hard,” she later told me. “I was doing for Jeff what I would have wanted Jeff to do for me.” Rogan soon made it clear he was morally opposed. “It would have been like putting a pillow over your father’s head,” he later told me.

Not long afterward, my mother declined additional medical tests and refused to put my father on a new anti-dementia drug and a blood thinner with troublesome side effects. “I take responsibility for whatever,” she wrote in her journal that summer. “Enough of all this overkill! It’s killing me! Talk about quality of life — what about mine?”

Then came the autumn day when she asked for my help, and I said yes. I told myself that we were simply trying to undo a terrible medical mistake. I reminded myself that my dad had rejected a pacemaker when his faculties were intact. I imagined, as a bioethicist had suggested, having a 15-minute conversation with my independent, predementia father in which I saw him shaking his head in horror over any further extension of what was not a “life,” but a prolonged and attenuated dying. None of it helped. I knew that once he died, I would dream of him and miss his mute, loving smiles. I wanted to melt into the arms of the father I once had and ask him to handle this. Instead, I felt as if I were signing on as his executioner and that I had no choice.

Over the next five months, my mother and I learned many things. We were told, by the Hemlock Society’s successor, Compassion and Choices, that as my father’s medical proxy, my mother had the legal right to ask for the withdrawal of any treatment and that the pacemaker was, in theory at least, a form of medical treatment. We learned that although my father’s living will requested no life support if he were comatose or dying, it said nothing about dementia and did not define a pacemaker as life support. We learned that if we called 911, emergency medical technicians would not honor my father’s do-not-resuscitate order unless he wore a state-issued orange hospital bracelet. We also learned that no cardiology association had given its members clear guidance on when, or whether, deactivating pacemakers was ethical.

(Last month that changed. The Heart Rhythm Society and the American Heart Association issued guidelines declaring that patients or their legal surrogates have the moral and legal right to request the withdrawal of any medical treatment, including an implanted cardiac device. It said that deactivating a pacemaker was neither euthanasia nor assisted suicide, and that a doctor could not be compelled to do so in violation of his moral values. In such cases, it continued, doctors “cannot abandon the patient but should involve a colleague who is willing to carry out the procedure.” This came, of course, too late for us.)

In the spring of 2008, things got even worse. My father took to roaring like a lion at his caregivers. At home in California, I searched the Internet for a sympathetic cardiologist and a caregiver to put my Dad to bed at night. My frayed mother began to shout at him, and their nighttime scenes were heartbreaking and frightening. An Alzheimer’s Association support-group leader suggested that my brothers and I fly out together and institutionalize my father. This leader did not know my mother’s formidable will and had never heard her speak about her wedding vows or her love.

Meanwhile my father drifted into what nurses call “the dwindles”: not sick enough to qualify for hospice care, but sick enough to never get better. He fell repeatedly at night and my mother could not pick him up. Finally, he was weak enough to qualify for palliative care, and a team of nurses and social workers visited the house. His chest grew wheezy. My mother did not request antibiotics. In mid-April 2008, he was taken by ambulance to Middlesex Hospital’s hospice wing, suffering from pneumonia.

Pneumonia was once called “the old man’s friend” for its promise of an easy death. That’s not what I saw when I flew in. On morphine, unreachable, his eyes shut, my beloved father was breathing as hard and regularly as a machine.

My mother sat holding his hand, weeping and begging for forgiveness for her impatience. She sat by him in agony. She beseeched his doctors and nurses to increase his morphine dose and to turn off the pacemaker. It was a weekend, and the doctor on call at Rogan’s cardiology practice refused authorization, saying that my father “might die immediately.” And so came five days of hard labor. My mother and I stayed by him in shifts, while his breathing became increasingly ragged and his feet slowly started to turn blue. I began drafting an appeal to the hospital ethics committee. My brothers flew in.

On a Tuesday afternoon, with my mother at his side, my father stopped breathing. A hospice nurse hung a blue light on the outside of his hospital door. Inside his chest, his pacemaker was still quietly pulsing.

After his memorial service in the Wesleyan University chapel, I carried a box from the crematory into the woods of an old convent where he and I often walked. It was late April, overcast and cold. By the side of a stream, I opened the box, scooped out a handful of ashes and threw them into the swirling water. There were some curious spiraled metal wires, perhaps the leads of his pacemaker, mixed with the white dust and pieces of bone.

A year later, I took my mother to meet a heart surgeon in a windowless treatment room at Brigham and Women’s Hospital in Boston. She was 84, with two leaking heart valves. Her cardiologist had recommended open-heart surgery, and I was hoping to find a less invasive approach. When the surgeon asked us why we were there, my mother said, “To ask questions.” She was no longer a trusting and deferential patient. Like me, she no longer saw doctors — perhaps with the exception of Fales — as healers or her fiduciaries. They were now skilled technicians with their own agendas. But I couldn’t help feeling that something precious — our old faith in a doctor’s calling, perhaps, or in a healing that is more than a financial transaction or a reflexive fixing of broken parts — had been lost.

The surgeon was forthright: without open-heart surgery, there was a 50-50 chance my mother would die within two years. If she survived the operation, she would probably live to be 90. And the risks? He shrugged. Months of recovery. A 5 percent chance of stroke. Some possibility, he acknowledged at my prompting, of postoperative cognitive decline. (More than half of heart-bypass patients suffer at least a 20 percent reduction in mental function.) My mother lifted her trouser leg to reveal an anklet of orange plastic: her do-not-resuscitate bracelet. The doctor recoiled. No, he would not operate with that bracelet in place. It would not be fair to his team. She would be revived if she collapsed. “If I have a stroke,” my mother said, nearly in tears, “I want you to let me go.” What about a minor stroke, he said — a little weakness on one side?

I kept my mouth shut. I was there to get her the information she needed and to support whatever decision she made. If she emerged from surgery intellectually damaged, I would bring her to a nursing home in California and try to care for her the way she had cared for my father at such cost to her own health. The thought terrified me.

The doctor sent her up a floor for an echocardiogram. A half-hour later, my mother came back to the waiting room and put on her black coat. “No,” she said brightly, with the clarity of purpose she had shown when she asked me to have the pacemaker deactivated. “I will not do it.”

She spent the spring and summer arranging house repairs, thinning out my father’s bookcases and throwing out the files he collected so lovingly for the book he never finished writing. She told someone that she didn’t want to leave a mess for her kids. Her chest pain worsened, and her breathlessness grew severe. “I’m aching to garden,” she wrote in her journal. “But so it goes. ACCEPT ACCEPT ACCEPT.”

Last August, she had a heart attack and returned home under hospice care. One evening a month later, another heart attack. One of my brothers followed her ambulance to the hospice wing where we had sat for days by my father’s bed. The next morning, she took off her silver earrings and told the nurses she wanted to stop eating and drinking, that she wanted to die and never go home. Death came to her an hour later, while my brother was on the phone to me in California — almost as mercifully as it had come to my paternal grandfather. She was continent and lucid to her end.

A week later, at the same crematory near Long Island Sound, my brothers and I watched through a plate-glass window as a cardboard box containing her body, dressed in a scarlet silk ao dai she had sewn herself, slid into the flames. The next day, the undertaker delivered a plastic box to the house where, for 45 of their 61 years together, my parents had loved and looked after each other, humanly and imperfectly. There were no bits of metal mixed with the fine white powder and the small pieces of her bones.

Katy Butler lives in Mill Valley, Calif., and teaches memoir writing at the Esalen Institute in Big Sur.

>> ^mintbbb:

>> ^ant:
This seems to be dead.

Thanks, fixed


Thanks. Darn, I thought yours was a dupe!

>> ^ant:

This seems to be dead.


Thanks, fixed

>> ^redyellowblue:

First stupid moment for me was Worm eye dude who said. "6 hours of day light left. phhhh, lets suit up and go out there. I wanna open my birthday presents" Dude, you just landed on an alien planet in a spaceship hotel. Maybe take your time? Survey the area thoroughly before going ALL THE WAY inside.


...just the tip?

Help Wanted: U.S. Geological Survey seeks Highly depressed virgins to placate volcano god. Applicants will get 3 days and 2 nights at one of Hawaii's finest hotels followed by a quick ceremony and a relaxing dip in Mount Kilauea's Halema'uma'u lava lake. Be a part of the team and apply today! Non-virgins need not apply.

>> ^Ickster:

Technological questions aside, the economics will likely never work for scheduled flights. Concorde was scrapped because it was a money loser, not because it didn't work. I don't see anything here that suggests a ticket on this thing wouldn't be astronomically expensive.


Actually this is wrong. The Concorde did lose money at first, but then they did a survey asking people how much they thought a ticket from NYC to London on the Concorde would cost, and the results of the survey was that everyone thought it was more expensive than they were actually charging. So then they decided to charge a lot more for the tickets and market it as a "luxury" flight. This gimmick was successful - it became more profitable than any other division of BA.

It was retired after the famous crash while taking off in France. Even though that was it's only crash, after long investigation, and decline in first class passengers, they never brought it back.

I'm glad that many of them made it to museums, because the Concorde was a phenomenal piece of engineering.

I have no idea how well this Reaction Engine will work, but I hope to see it succeed.

Dude, all they had to do was survey 10 apple users to get 10 "dumb ones"
>> ^Unsung_Hero:

These segments are funny but it always begs the question, "How many people did you have to interview to get the 10 dumb ones?" If you survey enough people you'll always have material.

These segments are funny but it always begs the question, "How many people did you have to interview to get the 10 dumb ones?" If you survey enough people you'll always have material.

Comment hidden because you are ignoring dag. (show it anyway)

http://www.pc.gov.au/research/visiting-researcher/productivity-slump
http://www.theaustralian.com.au/national-affairs/treasury/productivity-gap-holding-back-growth-as-survey-ranks-australia-second-last/story-fn59nsif-12
26439881599

http://www.smh.com.au/business/the-economy/australia-needs-productivity-jolt-mckinsey-20120816-249ye.html


>> ^kymbos:

Ok Dag, you got an independent reference for your productivity comment, or is that just based on your observations? Because the only people I see proclaiming that Australian labour has low productivity are people like Rinehart - rich people who would benefit from paying people less. I have seen no good evidence of low Australian labour productivity.>> ^dag:
To be fair - I didn't hear her say that Australians should be paid $2 per day.
And this might sting my Australian mates - but productivity is low in Australia. I'm in Canberra - which is probably low productivity HQ for the whole country.

Oh yea this theory has always been good stuff... actually the David Icke books are a good read for many different reasons...

David Icke Website
http://www.davidicke.com

"British author exposes the reptilian bloodline that rules the world."

"...human beings originated in a breeding program run by a race of reptilians called Anunnaki from the Draco constellation, and that what we call reality is just a holographic experience; the only reality is the realm of the Absolute"

For all his out-there theories he makes good points and gives food for thought:

"When you survey the world today ... when a child dies in this world of preventable disease every two seconds, when the economic system of this world must destroy the Earth simply for that system to survive; when you see all the wars, and when you see all the pain, and when you see all the suffering, is it a force of love and wisdom and tolerance that is in control of this planet?" -- david icke

>> ^shinyblurry:

The parameters of marriage was determined by God at the beginning of His creation. We have turned away from God in these United States, and so we have turned away from the biblical standard, however, not as much as gay marriage proponents have stated. Even with the media saturation and the constant infiltration of gay special interest groups into the national discourse, we have these realities:
1. A gay marriage amendment has never passed at the ballot box. It has failed everywhere it has been tried, with the voters rejecting it 32 times since 1998.
2. Constitutional bans on gay marriage have been successful 100 percent of time at the ballot box, passing in 31 states, typically with wide margins. This includes liberal strongholds like California and Hawaii. 38 states ban it to some degree.
The people don't appear to want gay marriage, and they are strongly in favor of the biblical definition of marriage. If you don't want to accept the reality that God has defined marriage, then accept the reality that most people are not that hot for this, and they don't want to take the country in this direction.
>> ^petpeeved:
>> ^shinyblurry:
If polygamy were legal, would it be a civil rights issue if he refused to bake one for a polygamous wedding? How about a cake for someone wanted to marry their dog, or their car? He believes marriage is between a man and a woman and refuses to make a cake for any other kind of wedding. This has nothing to do with their sexual orientation, it has to do with his moral opposition to the corruption of the institution of marriage.
>> ^petpeeved:
>> ^shinyblurry:
Don't try that shit, it's discrimination, you know exactly why he was refusing to make a gay wedding cake that type of lying isn't going to help your argument. 2nd it's not a double-standard to hand someone their ass when they say something stupid. You do something counter to the way a society has been going you get shouted down in the public square. We're moving towards legalizing gay marriage and giving equal rights to all americans, you go counter to that you're gonna get yelled at.
Sorry but you're wrong, it isn't discrimination. They were still able to do business there if they wanted another kind of cake, and I'm sure they're still welcome to do so. The man doesn't want to make a gay wedding cake because he believes marriage is between a man and a woman, and that gay marriage is immoral.
Also filth posted on message boards? Is this your first day on the internet? I'm pretty sure Justin Beiber hasn't done anything to anyone on the internet and still he's talked about worse than Hitler. You're in hyperbole country mother fucker, deal with it.
Now you want to continue discriminating against people and not doing your job to make cakes or hand out birth control pills than yeah your life is gonna be made harder. Too bad because you're lives are already way too easy as it is. Complaining about christian discrimination, bitch there's children dying in Africa, shut the fuck up.
So discrimination against Christians is okay, because people talk trash all the time and children are dying in Africa? In other words, you just wave your hand and make excuses..proving that you don't really think discrimination is wrong, so long as its against people you disagree with. It's clear you want equal rights for everyone except Christians.
>> ^Yogi

So blacks weren't being discriminated against on the buses and water fountains, because, hey, they could still ride...just not in the front of the bus and hey, they could get a drink...just not at this particular water fountain.
Sounds like the sequel to separate but equal.


You know what is the main flaw in the argument of Christians who claim that they have the sole right to define what the institution of marriage represents and who is permitted to access it?
Simply this:
Christians don't own, didn't invent, and have no right to control marriage. They don't hold the patent on it. Not the idea of marriage, not the word of marriage, nothing. The concept of marriage belongs to the human race and predates Christianity by millenia and continents. Therefore, they have no special rights or privilege to impose their definition of it upon the rest of the nation.
But don't take my word for it. You have google at your finger tips.



As much as I want to applaud you for shifting to a "fact" based argument with elements of reasoning as opposed to your pure belief based system of thought, I'm greatly confused as to where your statistics are coming from. I'm also a little irked that you forced me to do all the googling by the way. There are mountains of evidence that on every front, from the popular vote to constitutional challenges, that gay marriage is gaining support, not losing it.

Here, let me google it for you.

Just a few rulings on the constitutional level:

November 2003: the Massachusetts Supreme Judicial Court ruled that barring gays and lesbians from marrying violates the state constitution. The Massachusetts Chief Justice concluded that to “deny the protections, benefits, and obligations conferred by civil marriage” to gay couples was unconstitutional because it denied “the dignity and equality of all individuals” and made them “second-class citizens.” Strong opposition followed the ruling.

August 4, 2010: Chief U.S. District Judge Vaughn Walker ruled that Proposition 8, the 2008 referendum that banned same-sex marriage in California, violates the 14th Amendment's equal protection clause. "Proposition 8 singles out gays and lesbians and legitimates their unequal treatment," Vaughn wrote in his opinion. "Proposition 8 perpetuates the stereotype that gays and lesbians are incapable of forming long-term loving relationships and that gays and lesbians are not good parents."

February 7, 2012: the Ninth Circuit Court of Appeals in California ruled 2–1 that Proposition 8, the 2008 referendum that banned same-sex marriage in state, is unconstitutional because it violates the Equal Protection Clause of the 14th Amendment. In the ruling, the court said, the law "operates with no apparent purpose but to impose on gays and lesbians, through the public law, a majority's private disapproval of them and their relationships."

On the popular opinion front:

A June 6 CNN/ORC International poll showed that a majority of Americans support same-sex marriage being legalized at 54%, while 42% are opposed.

A May 22 NBC News/Wall Street Journal poll showed that 54% of Americans would support a law in their state making same-sex marriage legal, with 40% opposed.

A May 17-20 ABC News/Washington Post poll showed that 53% believe same-sex marriage should be legal, with only 39% opposed, a low-water mark for opposition in any national poll so far.

A May 10 USA Today/Gallup Poll, taken one day after Barack Obama became the first sitting President to express support for same-sex marriage,[14] showed 51% of Americans agreed with the President's endorsement. A May 8 Gallup Poll showed plurality support for same-sex marriage nationwide, with 50% in favor and 48% opposed.

An April Pew Research Center poll showed support for same-sex marriage at 47%, while opposition fell to an all-time low of 43%.

A March 7-10 ABC News/Washington Post poll found 52% of adults thought it should be legal for same-sex couples to get married, while 42% disagreed and 5% were unsure.[18] A March survey by the Public Religion Research Institute found 52% of Americans supported allowing same-sex couples to marry, while 44% opposed.

A February 29 - March 3 NBC News/Wall Street Journal poll found 49% of adults supported allowing same-sex couples to marry, while 40% opposed.

One last note on a slightly different topic: religious groups funding anti-gay legislation, most notoriously, the Prop. 8 campaign in California. If Christians are going to use their funds as a group, not individuals, why are they being given tax-free exemptions? Why should people, such as myself, who don't share their beliefs, subsidize their political ambitions?

“Congress shall make no law respecting an establishment of religion or prohibiting the free exercise thereof.”

I don't want the government to curtail the ability of the religious to practice their faith but I don't think the first amendment was intended to give religions the overwhelming competitive advantage of tax-free money at the ballot box.

This could be solved two ways: no more organizational level contributions to political campaigns, i.e. the close to 200k the Mormon Church donated to support Prop. 8, OR remove tax-exempt status from religions.

By the way, it might seem impossible to conceive of a time when tax-exempt status for religion wasn't taken for granted but it's been a controversial issue from the inception of America. For example, even President Grant and Madison were against tax-exemption for religions.