Balkinization  

Wednesday, July 11, 2007

Frankenstein and the Christian Scientist

Andrew Koppelman

I’m writing today in a foul mood, having learned from an old friend with whom I’ve recently reestablished contact that he is going to be moving to Canada because he’s quite ill, has no medical insurance, and will not receive the extended treatment he needs if he stays in the United States. And I recently returned from a conference, run by libertarians, at which it became clear that I was the only person there who was sure that a potent public sector was appropriate. I’ve been reflecting about the connection between these two data. I wondered what the libertarians would have to say to my friend. I’ve had difficulty putting words in their mouths that aren’t really, really stupid.

A frequent trope that the libertarians used, in our conversations, was the invocation of the terrible abuses that existed under Soviet communism. The idea that these exhaust the options on the table is weird. The following is an attempt to explain the weirdness.

Think about the question of treatment of illness – just on the individual level, as the individual decides what to do about his disease. One can imagine analogues to the communist and libertarian offering him advice. One advisor, let’s call him Dr. Frankenstein, suggests the following: “The problem with your body is that it operates by chance natural processes, without human direction. What you need to do is let me completely dismantle your body and put it together again in a completely different way, following a logic that I have carefully worked out, sitting here at my desk.” The other advisor, Christian Scientist, responds: “Your problem is that you haven’t got enough faith in the natural processes in your body. No intervention of any kind is appropriate, other than the prevention of basic physical trauma and starvation. Your body is a wonderfully self-regulating mechanism, which obviously takes care of itself most of the time without any medical intervention at all. It’s a mistake ever to try to interfere with its natural operation.”

Both Frankenstein and Christian Scientist are, not to put too fine a point on it, insane. The person needs medical intervention. The hard question is what kind of intervention he needs. There are sane presumptions that bear a family resemblance to both of these crazies: one can think that illness is evidence that intervention is appropriate, and one can also notice that, given the body’s capacities for self-regulation, intervention can sometimes do more harm than good. But both of these presumptions must await empirical testing, and each can be convincingly refuted in particular cases.

The communist and the libertarian are both loony for similar reasons. Economies are, for the most part, self-regulating, and the desire to micromanage them is crazy for the same reasons that Frankenstein is crazy. But the libertarian is no better. Our free market in medical care has created a state of affairs in which a large chunk of our population is vulnerable to easily preventable diseases, and in which the United States has become uninhabitable for some of its citizens, as my friend’s case illustrates. The faith that the market will fix this is as daft as the faith that prayer will cure my appendicitis.


Comments:

Thank you for an astute analysis. I was that kind of angry after watching 'Sicko'.

In a society where the main concern for those over fifty years of age is maintaining health, it may well be that a massive exodus to other countries is in the offing. I am certainly considering it.
 

Please, by all means, insult BOTH capitalists and Christians -- perhaps Hillary can hire you for her campaign -- I want your views publicized as much as possible!
 

Also, both ACLU members and people who advocate repealing the Bill of Rights are insane. The Bush Administration occupies the sensible middle ground. More generally, absolutists of any stripe, such as First Amendment absolutists, are insane.
 

Charles,

Not only is it insane to conflate "capitalist" with "libertarian" -- but to conflate "Christian Scientist" with "Christian" shows a lack of understanding so profound it's hard to fathom, not to mention that it was obviously a metaphor.

Are you prepared to admit also that you were wrong, and I, among others, was right about the effect of Libby's commutation on Bush's poll numbers? If you recall, you were all eager to "bet" (whatever that means) on the result, which has now begun to come in.
 

Good point, sean.
 

This comment has been removed by the author.
 

Please, by all means, insult BOTH capitalists and Christians -- perhaps Hillary can hire you for her campaign -- I want your views publicized as much as possible!

Oh yes, that makes perfect sense because all capitalists are neoliberals, just as all Christians are Christian Scientists. Similarly, all gases are helium, all trees are maples, and all senators are Thurmonds.
 

c2h50h and PMS:

I did not "conflate" anything -- Andrew Koppelman indeed posted the following: "The faith that the market will fix this is as daft as the faith that prayer will cure my appendicitis." That slanders BOTH the free market capitalist and the Christian.

As for Libby's commutation, I would very interested in Bush's poll number taking that into account (as well as the specific question / voter registration of those asked). No one ever took me up on that wager though.
 

Charles, just in case you didn't know, Christian Scientists are not the same as Christian scientists. Christian Science is a religion founded in the 19th century by Mary Baker Eddy, holding a number of views that mainstream Christians reject. One of those views is the belief that disease is not real, just a sign of lack of faith, and we should therefore reject all medical care as a matter of religious principle.

Obviously I don't know, but I suspect your own church disagrees with that. Terri Shiavo's church certainly did.
 

"The faith that the market will fix this is as daft as the faith that prayer will cure my appendicitis." That slanders BOTH the free market capitalist and the Christian.

This doesn't slur christians, this slurs nutcases. I doubt there are many christians who believe prayer will cure appendicitis.
 

Professor Koppelman:

Your friend may want to be darn sure that the government in Canada will actually supply this treatment in any timely fashion, especially if this is a terminal disease. The Canadians keep their medical costs lower than ours by rationing care and forcing their citizens in long queues. If your friend moves and cannot get care, there is no private alternative and he will have to come back to the US to get care like many Canadians already do.
 

Yes, I am well aware that "Christian Scientists" are a sub-set of all Christians -- my point was that "faith that prayer will cure my appendicitis [is insane, daft, etc.], irrespective of medical treatment or not, is "slander" to ALL people who believe in the ressurected Christ -- again, I "pray" Hillary has a spot on her campaign for Professor Koppelman.
 

Because resources are scarce and demand is infinite, all economies ration. Libertarians believe that that the market's rationing is good and the government's rationing is bad. Communists believe the reverse.

The government has stepped in to insure people whom the market would insure only at very high prices: Medicare covers the elderly and disabled. I personally think that Medicare should be means-tested and become a standard welfare program, but I recognise that this could be fatal to its political popularity.

Do the libertarians/100% capitalists in the audience think that their elderly parents should have to pay enormous amounts of money in order to obtain any medical care? I'm not asking because I'm necessarily opposed to the view; one could argue that the elderly have had their chance to make money, and if they haven't made enough to buy health care for their age, they were stupid. Since the most extreme libertarian view frequently regards children as extensions of their parents rather than as individual citizens with the potential for making independent demands on a purportedly equal opportunity society, there's no reason to insure low-income children, either, because if their parents haven't made enough to buy health care for the kids, the parents are stupid and the kids are part of that.

(If it's an insult to libertarians to say they call people stupid, feel free to amend it above as "unlucky and our society should not correct for any form of unluckiness except as people have paid for it -- by, for example, voluntarily joining risk-spreading insurance pools, and our society as a whole is not such a pool.")
 

saying that 'faith that prayer will cure my appendicitis' is 'daft' = insult to all Christians

Is Charles a man of the cloth? I know a couple of ministers and a Catholic priest, people from a large range of denominations including Mormons, and went to an Episcopalian private school growing up. I confess that I never heard that faith in prayer as a cure for appendicitis was necessary to being a Christian. I thought the necessary bit was believing that Christ is the Son of God who died for our sins and was Resurrected (not through the power of human prayer), and that following Him will lead us to our Father in Heaven.

I grew up among a lot of Baptists, and they all went to the doctor when they got appendicitis. But maybe they weren't really Christians. I don't recommend that Charles walk into Carpenter's Way and say that, though.
 

wasn't Luke a physician? was he not a Christian?
 

What part of "irrespective of medical treatment or not" are you people having trouble understanding?
 

Charles,

Frankly, "irrespective of medical treatment or not" is a shoddy phrase, so I don't think you should be surprised at our confusion.

Does your "or not" signify "irrespective of medical treatment or respective of medical treatment"? Does it signify "irrespective of medical treatment or medical nontreatment"? The "or not" seems potentially repetitive.

Are you trying to say that it is a tenet of Christian faith that prayer is capable of healing appendicitis should one lack access to medical care? If so, please cite authority for this statement. As I said, I have spent time with a large variety of Christians, and neither they nor any part of the New Testament that I have read supports such a claim.
 

Charles,

I can see two meanings of "irrespective of medical treatment or not." One is to accuse Prof. Koppelman of saying that even if you get medical treatment, prayer will not assist in your recovery. That is certainly not what he is saying.

The other is that it makes no difference whether you get medical treatment because either way prayer will heal you. This comes closer to what he is saying, but is not quite the point. Professor Koppelman's point is that Christian Scientists say that as a matter of religious principle you should not seek medical treatment because it shows a lack of faith in the power of prayer alone. That is what he is calling insane, and I think most mainstream Christians would agree.

So please, explain more clearly what you mean by "irrespective of medical treatment or not."
 

Oh, I certainly did not intend to confuse you with any shoddy phrasing -- and I never said that faith in prayer as a cure for appendicitis was "necessary" to being a Christian -- however, Jesus said unto him, "If thou canst believe, all things [are] possible to him that believeth." Mark 9:23. That's in the New Testament, last time I checked.
 

Charles,

Piling lies and weasel-worded equivocations on top of error is hardly an effective approach to discussion.

And from Bart I get the kind of idiotic, outrageous idiocy that just endears him to me: "Because resources are scarce and demand is infinite,"

Really? He should tell the economists. They can stop worrying about the law of supply and demand.
 

P.S. enlightened layperson -- I am not quibbling about the initial Christian Scientist jab -- why exactly do you think "faith that prayer will cure my appendicitis [is insane, daft, etc.]" necessarily excludes medical treatment as well?
 

Charles, you still haven't answered what you mean by "irrespecitve of medical treatment or not."
 

P.P.S. to C2H50H -- I wasn't aware that Mark 9:23 was deemed "weasel-worded equivocations" -- I'm sure you think they are lies though.
 

Enlightened Layperson:

I am indeed accusing Prof. Koppelman of saying that even if you get medical treatment, prayer will not assist in your recovery -- that is apparent to me in the last part of his post -- even if one does not get medical treatment, God can heal the appendicitis. That being said, I do not believe that faith in prayer as a cure is "necessary" to being a Christian -- however, as i pointed out "If thou canst believe, all things [are] possible to him that believeth."
 

Charles, do you claim that prayer by itself can heal appendicitis?
 

Of course: "If thou canst believe, all things [are] possible to him that believeth."
 

Or, as they say in Peru when you can't afford an operation: "Con Dios, todo es posible."

It's usually accompanied by a sad face and a shaking of the head though.
 

C2H50H,

That comment was mine. I only got a BA in economics, so if you went further and at the higher levels they show you graphs with a distinct endpoint for the demand line -- a price level of zero at which people wouldn't use up a valuable resource -- please share the link.

Charles,
Well, yes, Jesus does say that with faith all things are possible. So if Andrew says it's daft to believe that prayer could allow a man to jump off a building and float a few feet above the ground instead of smashing into it -- and that any man who attempts to put his belief into action ought to be straitjacketed -- you may consider that an insult to Christians, but I do not, and I seriously doubt that the vast majority of Christians would either. I am afraid that you make yourself the Al Sharpton of Christianity here.
 

well, then, you should check out this article, you'll love it!

http://www.theonion.com/content/node/28812
 

Bart,

I apologize. Paging got me (hit an extra pagedown, apparently).
 

PG,

Please forgive me.

Just as, when a libertarian says "taxes are theft" or Charles says "all things are possible" -- in order to understand that the speaker isn't just babbling, the hearer needs to know that the words are not to be interpreted literally, but in the sense of a particular mindset.

Now that I know you are an economist, I can appropriately interpret your meaning as meaning that demand far outstrips supply. Assuming, of course, that I can manage to figure out who is saying it and what you are referring to.
 

Charles

"Slandering" free markets and "slandering" christians? What makes you believe that an economic system or a generic religious category is so easily "slandered?"

That's as absurd as waging war on nouns.
 

PMS & PG:

We'll have to agree to disagree then.

Der Schatten:

Thing is, I never said "Slandering" an economic system or a generic religious category so that's what you call a strawman argument -- I'm a Christian and a capitalist -- the slander was against me as well.
 

Charles,

OK, so you believe that prayer can cure appendicitis. The next question should be, do you believe that this is an occasional, extraordinary miracle (in which case the prudent course is to seek medical treatment) or that prayer will always work if your faith is strong enough (in which case medical treatment is superfluous)?

Also, I do not see anywhere Prof. Kopelman saying that prayer cannot be used as a supplement to medical treatment.

The other advisor, Christian Scientist, responds: “Your problem is that you haven’t got enough faith in the natural processes in your body. No intervention of any kind is appropriate, other than the prevention of basic physical trauma and starvation. Your body is a wonderfully self-regulating mechanism, which obviously takes care of itself most of the time without any medical intervention at all. It’s a mistake ever to try to interfere with its natural operation.”

This refers to prayer instead of medical treatment, not prayer as a supplement to medical treatment. How clear can you be? Please point out to me the part of the post that rejects prayer as supplement to medical care. Professor Koppleman correctly portrays Christian Scientists a conscientious objectors to medical care. If you don't believe me, see here and here.
 

when are you people ever going to learn? i have stopped reading balkinization regularly because of the nonsense in posts like this. in case any of you looked, the subject of the post was the ridiculously sorry state of medicine in this country in which people are potentially forced to move to another country just to obtain treatment. the proper response was a debate over the system in the united states versus other countries, or the possible remedies within this country to cure such a ridiculous situation. the response, however, was what has all too often become the norm on this once excellent blog.

charles turned the subject into a completely irrelevant claim that his religion had been attacked, unless of course, charles is a christian scientist, which i do not believe he is. even if he is, his rant about an the post being an attack on religion is ridiculous.

sean chimed in with his usual snide and meaningless remark, and then stood aside to watch everyone tie themselves up in knots.

mr. depalma, while at least on point, to give him all the credit, did his usual parroting of the conservative line.

and all of you people fell for all of it. back and forth. back and forth on an alleged attack on religion, replete with quotes from the bible, and virtually nothing on point from the original post. when are you all going to learn just to ignore these idiots? absolutely pathetic.

as for me, even if my brother does contribute numerous posts on this blog, for the moment, you can count me out until the quality of discourse comes back to reality.
 

Sorry, phg and Enlightened Layperson, but it was not just Christian Scientists being attacked with the conclusing sentence: "The faith that the market will fix this is as daft as the faith that prayer will cure my appendicitis." If you can't handle that truth, by all means get out of the kitchen.
 

conclusing = concluding

Maybe if he had said ". . . as daft as the faith that prayer will cure THE CHRISTIAN SCIENTIST'S appendicitis" instead of broadening the claim?
 

as for me, even if my brother does contribute numerous posts on this blog, for the moment, you can count me out until the quality of discourse comes back to reality.

Just speaking for myself, one of the big advantages the internet has over a dinner party is this: at the dinner party I'm forced to listen politely to the boor sitting next to me. On the internet, I can skim down the posts and engage in dialogue with only those whose comments I find worthwhile.
 

Maybe if he had said ". . . as daft as the faith that prayer will cure THE CHRISTIAN SCIENTIST'S appendicitis" instead of broadening the claim?

So all this fuss was because you were offended that he said "as daft as the faith that prayer will cure my appendicitis" instead of "the Christian Scientist's appendicitis"?!?! Is there any good reason why you couldn't have said so at the beginning?
 

Perhaps I was just in a foul mood.
 

I'm confused as to why prayer would cure Koppelman's appendicitis but not the Christian Scientist's. But I will take phg's advice and discuss the point no more.
 

Is Andrew Koppelman related to Alex Koppelman?
 

phg: and all of you people fell for all of it...count me out until the quality of discourse comes back to reality.

You are right, of course.

Mark Field: ...I can skim down the posts and engage in dialogue with only those whose comments I find worthwhile.

And I seek to emulate your good example. But it is so much easier said than done. A thought: what would happen if a few of us made an explicit effort to address each other's comments as directly as possible, could we turn the tide that way? I think we could and that it is worth a try.
 

A thought: what would happen if a few of us made an explicit effort to address each other's comments as directly as possible, could we turn the tide that way? I think we could and that it is worth a try.

Have you ever read Robert Axelrod's The Evolution of Cooperation? It turns out that cooperators can actually come to dominate an environment once they reach a critical mass.
 

I guess I get yesterday's brain lapse of the day award for leaving out the most important part of my last post, namely the strategy that cooperators need to follow in order to succeed:

1. Interact with each other as much as possible.

2. Be nice to newcomers so that they'll cooperate too.

3. Interact as little as possible with those who refuse to play nice (but allow them in if they change their ways).
 

@Mark Field,

First, thanks for the Axelrod reference, I'll look to lay hands on a copy.

Second, the general sentiment as well as the three bullet points of strategy bear repeating as many times as you can find to work them into conversation.
 

Hi Andrew.

A mutual friend pointed me to this post, and suggested I add a comment. I'll do so, treating the matter historically, mostly perhaps because I read The Microbe Hunters (1940) by the great science-history popularizer Paul de Kruif about 20 times when I was a child, until the binding fell apart. So I'm going to answer Koppelman and Moore in Dekruifean style.

A one-paragraph clue to where I'm heading. It is inappropriate to say that a freemarket system for the provision of and financing of modern scientific medicine (MSM) has been tried and found wanting. The fact is, it has never been tried at all. To show this, we have to go into the 19th century development of MSM.

The American Medical Association was founded in 1847, to promote what its members already considered an orthodox or conventional model of medicine against challenges from homeopaths and mesmerists. (There were no Christian Scientists yet.) This is a curiosity itself. What did "orthodox medicine" mean in 1847? This was before Pasteur's discoveries had secured the germ theory of disease. Surgeons weren't physicians of any sort, they were still anybody skilled with a blade.

The defining characteristic of a physician, in the AMA/orthodox sense, in 1847 was the administration of "allopathic" drugs. Medicines that didn't resemble the suspected disease or poison. Allopathy -- "other than the disease." Obviously, this leaves possibilities wide open, and the particular drugs that would be administered to a patient by an allopathic doc in 1847 were those that had been selected by centuries of trial and error. The gastly connotations of that expression in this context are entirely fitting.

I think it is unlikely that any school of healing in 1847 was more likely to prolong your life than to shorten it. Or that any of the three contenders I've mentioned had a much better record than the other two. But the AMA's members were placing a sort of bet -- the homeopaths and mesmerists/mind-healers were placing contrary bets -- as to what would eventually prove to be the best approach to curing.

In 1855, the AMA put into effect what was called the “consultation clause” in its code of ethics. This clause meant that an orthodox practitioner risked expulsion (which at this point didn’t have the force of law, but we can think of it as a form of ‘shunning’ by one’s peers – in some contexts an effective psychological threat) if he so much as consulted with an unorthodox practitioner, i.e. a homeopath. This, you might say, was an effort at private-sector cartelization.

Lots of exciting stuff happened in the 1860s. In the United States, a civil war gave a lot of men opportunities to hone their skills as surgeons. They gained practical skill that the AMA would co-opt after the war, allying itself with surgery at last.

Meanwhile, in Europe, Louis Pasteur and Robert Koch put the "germ theory of disease" on a sound scientific basis in the 1860s. This also gave a foundation to the idea of allopathic medicine. If each disease has its own distinctive germ than the thing to do is to inoculate or immunize against that germ, or to find an agent that will kill off that germ without killing the
surrounding tissue.

Another development of the 1860s, this time in the British isles. Joseph Lister became the great proponent of an antiseptic surgical environment, specifically popularizing carbolic acid in this connection. The germ theory was an influence upon Lister, as one might expect. And his work helped undergird the alliance between physicians and surgeons.

So (returning to the US): after Appomattox, the AMA finally had something to sell. It was no longer just making a bet on something that might work, it had some science behind it. It was becoming an organization of entrepreneurs selling MSM.

It didn't take long thereafter, though, for the AMA to decide that private-sector cartelization, via such means as shunning, wasn't going to be enough to allow them to make the kind of profits for which they lusted. They started lobbying for licensure rules, essentially criminalizing the practices of their foes, and giving themselves control of entry into non-criminal healing.

Most of the states of the US have medical licensing laws that date to the quarter century 1875 - 1900.

So, to American's who can't get the insurance they need and/or the health care they need,and who are leaving the country to seek it elsewhere, what do I as an anarcho-capitalist have to say? To begin: God's speed. I wish you the best. Second, though, I should say that such anecdotes don't and shouldn't guide us as to the proper direction of reform. The proper direction would be, at last, to give a try to something that doesn't seem ever to have been seriously attempted, the de-licensing of modern scientific medicine, a true post-Pasteur privatization of the field.

Will Wilkinson, of The Fly Bottle, has expounded upon this a bit. Here's the money quote:

"There ought to be a guy, Manny, say, who does stitches. You cut your arm and you go to Manny’s stitches joint, which flourishes because Manny is the best at stitches. Manny leaves no scar! Ever! Moreover, he’s cheaper that some guy who spend years learning about the biochemistry of the human body. What does that have to do with stitches!? Why isn’t there a Manny’s Stitches Joint! You should be able to get a degree from the University of Phoenix in knee replacements. Just knee replacements! Why can’t you?! Because the AMA is evil. M.D.s are monopolists and welfare queens, and preventing a huge infusion of high-quality low-cost health care providers from coming to market."

Here's more on Wilkinson's tack, from his blog. http://www.willwilkinson.net/flybottle/2006/03/19/health-care-fantasia/
 

My comment to this blog is the man you are talking about is my fiance' and i have lived with him and this disease and the hell the goverment has put him or should i say us through just trying to get him help you know it is really sad when you live in a country that celebrates the fourth of july as independence day how can we be celebrating a holiday that that says we are free but when in all actuality we are not because in the united states we have to pay for our freedom in my fiance' case he is paying this freedom with his life! Misty Sparks
 

Hi, Misty. I am sorry you and your fiance' are going through this disease, but a "free" United States has never meant free healthcare, etc. Good luck in Canada though. Whether you want to believe in it or not, I will say a prayer for you both.
 

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