Thursday, March 31, 2005

Columbia University has just released a report on the results of its investigation into the conduct of certain of its professors of Middle Eastern Studies. The investigating committee consisted largely of faculty conspicuously sympathetic to the professors in question. And, indeed, the report they produced largely exonerates the professors of wrongdoing, and even criticizes the accusers, who have themselves been accused of trying to undermine the professors' "academic freedom".

Let's take for granted (I certainly do) that the accusations against these professors--all of them virulent, even militant critics of the state of Israel--have more to do with the politicized nature of their scholarship than with any real or alleged misconduct. If one were a believer in "academic freedom", then any discussion of the legitimacy of these accusations would end there. But as I've explained before, I consider "academic freedom" to be primarily a cover for eviscerating academic standards, and allowing political propagandists, purveyors of pseudo-scholarly nonsense, or just plain useless deadwood to keep their cushy academic sinecures. There remains the question, though: how is a university supposed to defend academic standards against "academic freedom"?

University administrators are often confronted with this question when an embarrassing faculty member--or sometimes an entire department--is noticed to be producing and teaching propaganda, or nonsense, or nothing at all, instead of serious scholarship. The standard approaches are (1) allowing (or quietly encouraging) more competent scholars to develop somewhere else on campus, whence they can marginalize and overshadow the cranks until the latter retire or leave of their own volition; or (2) giving the offending cranks a push, by digging up "offenses" on their part to justify active measures against them. Ward Churchill's treatment was an example of the latter approach--after the politically incendiary nature of his scholarship became embarrassing to the university, numerous incidents of plagiarism and poor scholarship that were previously papered over suddenly came to light, allowing the university administration to justify taking action. In another case, a professor who openly espoused Nazism was turfed out for excessive absenteeism.

Likewise, the Columbia professors' accusers were clearly trying to give the university an excuse to clean house in the Middle Eastern Studies department. Unfortunately, the university administration refused to take the hint, and instead threw its weight behind the professors' "academic freedom". The result will be more garbage pseudo-scholarship emanating from the Columbia Middle Eastern Studies faculty.

Defenders of "academic freedom" will no doubt argue that it can protect outstanding scholars with controversial political views. (Indeed, some of them will make that very argument in this case.) But in practice, those who are more interested in, say, political conformity than in good scholarship are perfectly willing to denigrate good scholarship in the name of political conformity--while using "academic freedom" to protect politically conformist bad scholarship. "Academic freedom" is thus a much more powerful weapon in the hands of the defenders of bad scholarship than for the defenders of good scholarship. It's bad for academia, and deserves to be discredited.

Sunday, March 20, 2005

Eugene Volokh and Mark A.R. Kleiman have been debating a somewhat grisly topic: whether it would be just and moral to torture a heinous criminal (say, a serial killer of children) to death, as retribution for his crimes. They appear to have come to agreement, in the end, that purely retributive punishment of this sort is morally just, but nevertheless operationally impracticable, for various reasons.

Needless to say, I disagree. I support severe measures--such as capital punishment, and even torture--when necessary for legitimate purposes, such as deterrence or prevention of even worse misdeeds. But I strongly oppose mistreating criminals merely out of vengeful cruelty.

I've already articulated my views on these issues at length, and there's not much point in any event in arguing over such fundamental moral disagreements. But I feel compelled to respond to what Kleiman and Volokh apparently consider the clinching argument in favor of retributive justice. As Kleiman puts it:
[C]ould you explain to me why we kept chasing Nazi war criminals well into the 1990s? Was the Third Reich likely to come back? Were we hoping to deter the next round of mass murderers?
Perhaps it's the perpetually warm, sunny weather in Los Angeles that's convinced UCLA professors Kleiman and Volokh that monsters comparable to the Nazi war criminals are purely relics of the past. But those of us with a darker--and, I believe, far more realistic--view of the world see the Nuremberg trials, and subsequent Nazi-hunting, as a serious exercise in deterrence. That's presumably why grand, public trials were held, rather than standard military court martials. That's why the accusers, judges and executioners were from the victorious allies who defeated the Nazis, not from the nations and peoples that the Nazis overran and decimated. That's why the slogan of the Nazi-hunters is "never again"--rather than, say, "torture the bastards". That's why the governments that sheltered Nazi war criminals from prosecution were not those given to expressing horror at the idea of retribution, but rather those, like Syria's and Argentina's, given to voicing sympathy with Nazi ideas. And that's why the iconic monstrosity of the Nazis is used regularly today, along with the stories of similar monsters who got off scot-free, such as Stalin and Pol Pot, to call us to action against contemporary horrors--whereas the fates of those whose cruelties were brutally avenged, such as, say, Italy's Mussolini, Rumania's Ceausescu, or Nicaragua's Somoza, are rarely, if ever, used as moral exemplars of any kind.

Perhaps it's naive to think that power-hungry, megalomaniacal sadists would be deterred by the threat of being brought to justice. Then again, perhaps it's naive to think that everyday criminals are so deterred, either. Obviously, criminals of all types do what they do because deterrence has failed to intimidate them--and perhaps some are, indeed undeterrable.

What we do know, however, is that Hitler is said to have remarked, just prior to his invasion of Poland, "who today remembers the extermination of the Armenians?" And the Nazis certainly went to considerable effort and expense to keep the scale and many of the details of the Holocaust as secret as possible--even when the Nazi empire was at the height of its power, openly committed to many frankly brutal ends, and in a state of total war with virtually all the countries that could possibly threaten it. Perhaps the fear of being called to account for their crimes did weigh on the minds of the Nazi killers, after all. And if even they felt at least some shred of culpability-inspired inhibition, then who else might?

Sunday, March 13, 2005

Should doctors be using computers?
The New York Times often goes out of its way to make it clear that everything bad that happens, or that might be happening, is about Bush and his administration. One example is this article entitled, "Under Bush, a New Age of Prepackaged Television News". In paragraph 12 they tell us that this practice "also occurred in the Clinton administration". I guess that was the Previous Age.

But what especially upsets me now is that the Times administration has decided that in order to aid their Bush-bashing, they have to come out against the computerization of medical records. At least for now. As I've mentioned before, I have a long standing interest in this subject. I think it is absurd that computers are not used more to keep track of patients' medical records and of the decisions of their physicians. Obviously this should be computerized, and obviously it should be done well and not badly.

The article begins with a really damning attack against Bush: "The Bush administration and many health experts have declared that the nation's health care system needs to move quickly from paper records and prescriptions into the computer age." We are not told just when the administration declared this, nor what they might mean by "quickly". We are told that Dr. David Brailer, the administration's national coordinator for health information technology, took issue with "the suggestion that the Bush administration is encouraging a headlong rush to invest in health information technology". We are not told who made this "suggestion", nor are we given any evidence for it. Brailer says that "for the next year, ... his policy efforts will be to try to encourage the health industry to agree on common computer standards, product certification and other measures that could become the foundation for digital patient records and health computer systems." That certainly sounds like a headlong rush to me.

Just why is the New York Times so afraid of doctors using computers? The excuse is three articles that appeared Wednesday in the Journal of the American Medical Association; all of the abstracts, and the text of one of them, can be read for free. These papers apparently "cast doubt on the wisdom of betting heavily that information technology can transform health care anytime soon".

[The paper by Koppel et. al.] found 22 ways that a computer system for physicians could increase the risk of medication errors. Most of these problems, the authors said, were created by poorly designed software that too often ignored how doctors and nurses actually work in a hospital setting.

The likelihood of errors was increased, the paper stated, because information on patients' medications was scattered in different places in the computer system. To find a single patient's medications, the researchers found, a doctor might have to browse through up to 20 screens of information.

Among the potential causes of errors they listed were patient names' being grouped together confusingly in tiny print, drug dosages that seem arbitrary and computer crashes.

... The study did not try to assess whether the risks of computer systems outweigh the benefits, like the elimination of errors that had been caused by paper records and prescriptions.
In fact, the paper tells us (although the Times does not) that, "Published studies report that CPOE reduces medication errors up to 81%." This is the benefit we apparently get even from a program that is horribly designed and atrociously implemented. The program in question has been in use since 1997, presumably as part of Bush's headlong rush.

Dr. Koppel tells the Times that he is "skeptical of the belief that broad adoption of information technology could deliver big improvements in health care". I guess he wasn't present when my sister took our father to the hospital and had to describe (over and over again) his medical history of cancer, diabetes, high blood pressure, Parkinson's, and Alzheimer's, and the medication he was taking for each of these. I guess Dr. Koppel was never present in an emergency room where patients similar to my father come in -- often by themselves -- all the time.

The JAMA issue also has an editorial that propounds at great length the remarkable insight that people designing computer systems should be very familiar with the needs and the practices of the intended users. It also asserts that, "health care ... is from an organizational standpoint probably the most complex enterprise in modern society." This is highly questionable.

Another paper examines more generally computer support systems used by doctors. Or rather, it examines a whole lot of studies that examined these systems. It concludes: "Many CDSSs improve practitioner performance. To date, the effects on patient outcomes remain understudied and, when studied, inconsistent." The Times article didn't have room for this conclusion, but they did say:
[The editorial] found that most of the glowing assessments of those clinical decision support systems came from technologists who often had a hand in designing the systems.

"In fact, 'grading oneself' was the only factor that was consistently associated with good evaluations," observed the journal's editorial ...".
This last statement from the editorial isn't true. Other factors given involve whether or not practitioners used the system, the usability and integration of the system into practitioner workflow, practitioner acceptance of computer recommendations, and the presence of automatic prompting. And the authors point out that there are reasons beside (obvious) bias why people who are involved in both evaluating and designing a system might produce a system that evaluates better.

Of course, the Times provides token balance by experts. But it makes sure to tell us that "even those experts conceded that the articles raised some good points."

It would be nice if the Times would tell us what, exactly, should be done. How much longer should we expect it to take to develop these computer systems, or should we just give up on the absurd idea of doctors using computers? Perhaps we should take away those dangerous, flawed computer systems from nuclear reactors and air traffic control. Perhaps New York Times writers should go back to using typewriters pencil and paper to record their work.

Wednesday, March 09, 2005

"Why is everyone mad at the mainstream media?", is the subtitle of a recent New Yorker article by renowned journalist and author Nicholas Lemann. "Mainstream journalists want to think that the public is aware of--and respects--the boundaries that separate real journalism from entertainment, and opinion, and propaganda, and marketing," he writes. It appears, though, that "instead, the public....doesn’t accept that [real journalism] really is distinct and superior." Lemann, deeply concerned, set out to investigate.

And where would this esteemed scribe go to study the American news-consuming public, and to try to understand its newfound disdain for "real journalism"? Intrepid fact-finder that he is, Lemann seeks out....Bill Keller, executive editor of the New York Times; Ann Marie Lipinski, editor-in-chief of the Chicago Tribune; Leonard Downie, Jr., editor-in-chief of the Washington Post; Jim Kelly, managing editor of Time magazine; James Warren, the deputy managing editor for features at the Tribune; Don Wycliff, the Tribune’s public editor; Neal Shapiro, the president of NBC News; and--for a couple of paragraphs,three-quarters of the way through the piece--a single non-journalist: Ed Gillespie, former chair of the Republican National Committee.

Of course, those were only the interviewees Lemann actually quoted in the article. He may have talked to more people, since he mentions that he "spoke to the heads of several large news organizations". According to him, "all of them maintained that they get attacked from both political sides, and agreed that both the amplitude and the frequency of the attacks seem to be increasing." Generally, though, the editors were baffled as to the causes of "the constant low hum of political objection to what they do." Keller offered, "I think conservatives feel this way in part because for years they’ve been told they should feel this way." Warren "was frustrated that what seems obvious to him and his colleagues evidently doesn’t to their audience." Says Wycliff: "I just think the people out there who write to me, who call me, they do not have the governors on their behavior that we have in our industry."

According to Lemann, "[t]his is what journalists in the mainstream media are starting to worry about: what if people don’t believe in us, don’t want us, anymore?" He set out to answer this question, asked a bunch of fellow journalists, and got nowhere. Yet the answer was right there, in plain sight, in his own magazine article--if only he'd made the tiniest effort to look at it, for once in his life, from a slightly different perspective.

Saturday, March 05, 2005

The controversy surrounding a recent Los Angeles Times article by Korea correspondent Barbara Demick suggests that the practice of journalism in America may be in for a momentous change. Conservative bloggers have pummeled Demick for the article, in which a North Korean official cheerfully defends his government's record, completely unchallenged. She's even been compared to Walter Duranty, the notorious New York Times journalist who filed glowing dispatches about Stalinist Russia during the Great Terror of the 1930's.

Well, it turns out that the story isn't that simple. Apparently, Demick has written at length about the horrors of the North Korean Regime after all. Then there's this article, from this past fall, in which Demick ruminates on the difficulty of reporting on North Korea while being barred from the country. And now, a few months later, we read Demick obediently parroting the North Korean government's propaganda.

I believe what we have here is a classic example of the foreign correspondent's version of a "source greaser". A couple of years ago, when it was revealed that CNN had prettified its coverage of Saddam Hussein's regime in Iraq in return for "access", I pointed out that domestic journalists do this sort of thing all the time, buttering up sources in return for juicy tidbits. It's hardly surprising, then, that reporters traveling abroad pack a similarly lax set of scruples, when it comes to getting information about countries where the flow of information is tightly controlled by the government. I strongly suspect that Barbara Demick is playing this game--filing some obsequious reports about North Korea in the hope of getting a journalist's visa, where (she imagines) she can get the real scoop on the country.

What's interesting about this case is that it demonstrates the way the collapse of the media establishment (of which blogs are only one part) has opened up journalists' practices--including source-greasers--to withering scrutiny. As a result, many standard journalistic practices--source-greasers among them--may now be impossible to get away with.

That's not a bad thing. Source-greasers are part of an inherently dishonest transaction, whose only beneficiaries are the journalist and the source. The source gets both flattering press and the opportunity to mislead the public by feeding the journalist "scoops" of his or her choice, and the journalist gets preferential access to these scoops. The public is the clear loser from this type of transaction, and its abolition can only improve journalism.

In the case of foreign reporting, scrutiny of journalistic practices is particularly difficult, because the audience is inherently less well-informed about the topic, and therefore less able to assess the credibility of the journalists. But if the CNN and LA Times cases are any indication, even foreign correspondents may soon be constrained by media watchdogs to report in something resembling an honest fashion. That would certainly be a tremendous improvement.

Tuesday, March 01, 2005

Elections in Iraq and the Palestinian territories, democratization in Egypt, pro-democracy and anti-Syrian protests toppling the government in Lebanon, even some democratic noises in Saudi George W. Bush's grand plan--to counter Islamist terror by toppling Saddam Hussein, thus igniting democratic revolutions across the Arab world--succeeding?

There are actually three parts to that question:

  • Are recent events in the aforementioned countries manifestations of a wave of democratic revolutions sweeping across the Arab world?

  • Is US policy--in particular, the invasion of Iraq--responsible for them?

  • Should they be regarded as positive developments from the point of view of American interests?

  • Conservatives are generally inclined to answer "yes" to all three questions. Their star witness is Lebanese Druze leader Walid Jumblatt--not exactly a paragon of the democratic spirit--whom the Washington Post's David Ignatius nevertheless quoted as saying,
    It's strange for me to say it, but this process of change has started because of the American invasion of Iraq....I was cynical about Iraq. But when I saw the Iraqi people voting three weeks ago, 8 million of them, it was the start of a new Arab world.
    Interestingly, the left offers a fair bit of qualified agreement--including even some credit to the Bush doctrine and its application in Iraq. There is general admiration for the elections there and for the new post-Arafat order among the Palestinians; particular satisfaction over Mubarak's concessions in Egypt; and widespread skepticism only regarding prospects in Lebanon. (Particularly amusing is Flynt Leverett's New York Times Op-Ed warning about the possible disastrous consequences of Syria losing control of Lebanon. He warns that the US might have trouble "containing Hezbollah without on-the-ground Syrian management"--as if Syria weren't Hezbollah's primary lifeline.)

    In fact, leftist skeptics are correct in not swallowing conservative triumphalism whole--democracy is far from a done deal in any of these countries. Their skepticism, however, isn't necessarily wisely distributed.

    Possibly the most promising case is Lebanon, which was at least somewhat democratic before civil war broke out in 1976, and whose current dictatorial government is foreign-imposed. Its foreign occupier, Syria, is now straining under American and even some international pressure to leave Lebanon to the Lebanese. For Syria, the fall of Saddam Hussein meant the elimination of a major source of distraction from Syria's misdeeds, and of much-needed oil-smuggling revenue.

    On the other hand, the Syrians have enormous incentive not to give up so easily--their economy is heavily dependent on its plunder of more prosperous Lebanon--and a long record of being as ruthless as they need to be. If Syria were to react to Lebanese rebellion not by withdrawing its troops, but rather by sending its tanks into the streets of Beirut, it's highly doubtful that there would be any significant Lebanese resistance, and foreign intervention--American or Israeli--is no more likely. Driving Syria out of Lebanon will require much more than a few civilian protests--sustained economic, political, and perhaps even military pressure may be necessary. Fortunately, Syria's government is in a very weak position, and Europe and America are unusually united in this effort.

    The new government in Iraq has, in some ways, better prospects than the Lebanese democrats--after all, a supportive American occupation is much less of an obstacle than Syrian hegemony. But Iraq's population is at least as fragmented as Lebanon's, and has an even worse historical record of hostility. Moreover, Iraq's domineering neighbor, Iran, is as ruthless as Syria, and much more resilient to Western pressure. American troops can head off an actual invasion, and help suppress terrorist uprisings. But they can't prevent Iraq's government from disintegrating into ethnic, tribal or regional warfare, or falling into Iran's orbit quasi-voluntarily.

    At least Iraq's democracy is off to a fairly promising start. Egypt's and Saudi Arabia's token gestures towards democracy are neither sincere nor likely to be fruitful. Neither country has anything like a viable democratic opposition, although both are threatened by thriving Islamist terrorist movements. Under the circumstances, democracy's poor prospects in these nations may not actually be an unalloyed misfortune--particularly for the US, but also for citizens of those countries, considering the precedent of Algeria's unfortunately premature democratic experiment in the early 1990s.

    As for the Palestinians, their recent exercise in democracy spoke volumes. The new Palestinian Authority President, Mahmoud Abbas, actually has a remarkably good record as a supporter of peace and reconciliation with Israel. But Palestinian society is still clearly dominated by supporters of never-ending, all-out terrorism--and not, needless to say, by democratic reformers--and Abbas has no power even to take significant action against the terrorists, let alone to defeat them. Perhaps one day there will be enough popular support for peace with Israel to mount a credible opposition to the terrorist warlords who effectively rule the territories. But that day still looks very far off.