Proof of prespecified endpoints in medical research with the bitcoin blockchain

NOTICE (2022-05-24)

This blog post was written in 2014, when I still naively hoped that the myriad problems with cryptocurrency might still be solved. I am now somewhat embarrassed to have written this in the first place, but will leave the post up for historical reasons. (Quite a number of medical journal articles link here now, for better or for worse.)

While the following methods are valid as far as they go, I absolutely DO NOT recommend actually using them to timestamp research protocols. In fact, I recommend that you never use a blockchain for anything, ever.

Introduction

The gerrymandering of endpoints or analytic strategies in medical research is a serious ethical issue. “Fishing expeditions” for statistically significant relationships among trial data or meta-analytic samples can confound proper inference by statistical multiplicity. This may undermine the validity of research findings, and even threaten a favourable balance of patient risk and benefit in certain clinical trials. “Changing the goalposts” for a clinical trial or a meta-analysis when a desired endpoint is not reached is another troubling example of a potential scientific fraud that is possible when endpoints are not specified in advance.

Pre-specifying endpoints

Choosing endpoints to be measured and analyses to be performed in advance of conducting a study is a hallmark of good research practice. However, if a protocol is published on an author’s own web site, it is trivial for an author to retroactively alter her own “pre-specified” goals to align with the objectives pursued in the final publication. Even a researcher who is acting in good faith may find it less than compelling to tell her readers that endpoints were pre-specified, with only her word as a guarantee.

Advising a researcher to publish her protocol in an independent venue such as a journal or a clinical trial registry in advance of conducting research does not solve this problem, and even creates some new ones. Publishing a methods paper is a lengthy and costly process with no guarantee of success—it may not be possible to find a journal interested in publishing your protocol.

Pre-specifying endpoints in a clinical trial registry may be feasible for clinical trials, but these registries are not open to meta-analytic projects. Further, clinical trial registry entries may be changed, and it is much more difficult (although still possible) to download previous versions of trial registries than it is to retrieve the current one. For example, there is still no way to automate downloading of XML-formatted historical trial data from www.clinicaltrials.gov in the same way that the current version of trial data can be automatically downloaded and processed. Burying clinical trial data in the “history” of a registry is not a difficult task.

Publishing analyses to be performed prior to executing the research itself potentially sets up a researcher to have her project “scooped” by a faster or better-funded rival research group who finds her question interesting.

Using the bitcoin blockchain to prove a document’s existence at a certain time

Bitcoin uses a distributed, permanent, timestamped, public ledger of all transactions (called a “blockchain”) to establish which addresses have been credited with how many bitcoins. The blockchain indirectly provides a method for establishing the existence of a document at particular time that can be independently verified by any interested party, without relying on a medical researcher’s moral character or the authority (or longevity) of a central registry. Even in the case that the NIH’s servers were destroyed by a natural disaster, if there were any full bitcoin nodes left running in the world, the method described below could be used to confirm that a paper’s analytic method was established at the time the authors claim.

Method

  1. Prepare a document containing the protocol, including explicitly pre-specified endpoints and all prospectively planned analyses. I recommend using a non-proprietary document format (e.g. an unformatted text file or a LaTeX source file).
  2. Calculate the document’s SHA256 digest and convert it to a bitcoin private key.
  3. Import this private key into a bitcoin wallet, and send an arbitrary amount of bitcoin to its corresponding public address. After the transaction is complete, I recommend emptying the bitcoin from that address to another address that only you control, as anyone given the document prepared in (1) will have the ability to generate the private key and spend the funds you just sent to it.

Result

The incorporation into the blockchain of the first transaction using the address generated from the SHA256 digest of the document provides an undeniably timestamped record that the research protocol prepared in (1) is at least as old as the transaction in question. Care must be taken not to accidentally modify the protocol after this point, since only an exact copy of the original protocol will generate an identical SHA256 digest. Even the alteration of a single character will make the document fail an authentication test.

To prove a document’s existence at a certain point in time, a researcher need only provide the document in question. Any computer would be able to calculate its SHA256 digest and convert to a private key with its corresponding public address. Anyone can search for transactions on the blockchain that involve this address, and check the date when the transaction happened, proving that the document must have existed at least as early as that date.

Discussion

This strategy would prevent a researcher from retroactively changing an endpoint or adding / excluding analyses after seeing the results of her study. It is simple, economical, trustless, non-proprietary, independently verifiable, and provides no opportunity for other researchers to steal the methods or goals of a project before its completion.

Unfortunately, this method would not prevent a malicious team of researchers from preparing multiple such documents in advance, in anticipation of a need to defraud the medical research establishment. To be clear, under a system as described above, retroactively changing endpoints would no longer be a question of simply deleting a paragraph in a Word document or in a trial registry. This level of dishonesty would require planning in advance (in some cases months or years), detailed anticipation of multiple contingencies, and in many cases, the cooperation of multiple members of a research team. At that point, it would probably be easier to just fake the numbers than it would be to have a folder full of blockchain-timestamped protocols with different endpoints, ready in case the endpoints need to be changed.

Further, keeping a folder of blockchain-timestamped protocols would be a very risky pursuit—all it would take is a single honest researcher in the lab to find those protocols, and she would have a permanent, undeniable and independently verifiable proof of the scientific fraud.

Conclusion

Fraud in scientific methods erodes confidence in the medical research establishment, which is essential to it performing its function—generating new scientific knowledge, and cases where pre-specified endpoints are retroactively changed casts doubt on the rest of medical research. A method by which anyone can verify the existence of a particular detailed protocol prior to research would lend support to the credibility of medical research, and be one less thing about which researchers have to say, “trust me.”

Le trottoir, c’est pour les piétons

Ne faites pas du vélo sur le trottoir. Il ne faut jamais faire ça. Si vous ne vous sentez pas en sécurité dans la rue, descendez de votre vélo et marchez à côté.

(English version follows)

Pourquoi ne devrais-je pas faire du vélo sur le trottoir?

  • C’est contre la loi
  • C’est dangereux pour les piétons
    • Vraiment dangereux
    • Vous pouvez tuer quelqu’un
    • Vous pouvez handicaper une personne
    • Vous n’avez pas le droit de decider du niveau de danger auquel vous soumettez les piétons

Mais, les autos ne suivent pas les lois parfaitement eux non plus

Vous avez quoi? Comme six ans? Si quelqu’un d’autre enfreint les règles ça ne vous donne pas le droit de le faire aussi. La loi s’applique aux vélos. Non, vous n’êtes spécial ni un cas particulier.

Mais, parfois, faire du vélo sur le chemin, c’est dangereux pour moi!

  • Modifie ta route pour prendre la piste cyclable, autant que possible
  • Vous pouvez toujours descendre de votre vélo et marchez à côté, si vous devez prendre cette route en particulier, et si emprunter la rue est trop dangereux

Si vous faites du vélo sur le trottoir au lieu de marcher à côté de votre vélo, et vous vous dites, “je fais ça à cause du danger dans la rue,” vous ne vous dites pas “ma sécurité est aussi important que n’importe qui d’autre.” Vous dites, “ma personne et mon plaisir est plus important que la sécurité d’un piéton.” Et ça fait de vous un douchewad.

Vous ne pouvez pas vous attendre à ce que je marche à côté de mon vélo!

Oui. Je peux. Même si ça prend un 30 secondes de plus pour aller sur la piste cyclable. Vous allez survivre.

Mais je porte mes chaussures à vélo et je ne peux pas marcher avec!

Si votre choix de chaussure fait qu’il vous est impossible de respect la loi et emprunter les rues de la ville de manière sécuritaire mais pas juste pour vous, pour les autres aussi—piétons incluent—donc, vous devez choisir plus attentivement lorsque vous aller jouer avec vos jouets de vélo spécial.

Oui, je l’ai dit—vos chaussures à vélo ne sont rien d’autre que des jouets de vélo spécial, et le plaisir que vous avez avec ces jouets à vélo spécial n’est pas plus important que le sécurité de quelqu’un d’autre.

Si je ne peux pas porter mes chaussures à vélo quand je vais au travail, quand est-ce que je vais les porter?

Je ne sais tellement pas! Peut-être au Tour de France!

Je sais que vous prenez ça sérieusement, mais, les chaussures à vélos sont des équipement sportifs spécialisés et leur place est dans une course de vélo (où la police a bloqué la rue), ou sur les pistes cyclable, ou n’importe où, si le plaisir que vous tirez de cet équipements sportif spécialisé n’interfère pas avec la sécurité des autres.

Pour résumer

Ne pas faire de vélo sur le trottoir.

Descendez de votre vélo et marchez à côté.


Don’t ride your bike on the sidewalk. Ever. If you don’t feel safe on the road, get off your bike, and walk with it.

Why shouldn’t I ride my bike on the sidewalk?

  • It’s against the law
  • It’s dangerous for pedestrians
    • Actually dangerous
    • Life-in-danger dangerous
    • Permanent-disability dangerous
    • It shouldn’t even matter how dangerous it is, you shouldn’t get to choose what level of risk I have to bear as a pedestrian

But cars don’t follow traffic laws perfectly either!

What are you, six years old? You don’t get to break the rules just because someone else did. The law applies to cyclists. You are not a special case.

But in some places, it’s dangerous for me to ride on the road!

  • Modify your route to take the bike path, where possible
  • You can always get off your bike and walk if you need to take that particular path and it’s too dangerous to be on the road

If you ride your bike on the sidewalk rather than walking with your bike on the sidewalk, and you say that you’re doing it because it’s dangerous for you on the road, you are not saying “my safety is as important as anyone else’s.” What you are saying is “my convenience is more important than a pedestrian’s safety,” which makes you a douchewad.

You can’t expect me to walk my bike!

Yes I can. Even if it takes you an extra 30 seconds to get to the bike path every morning. You will survive.

But I’m wearing bike shoes that I can’t walk on!

If your choice in footwear makes it impossible for you to obey the law and conduct yourself through the city in a manner that is safe not just for yourself but also for those around you—including pedestrians—then you need to choose more carefully when it is that you play with your fancy bike toys.

Yes, I said it—your bike shoes are fancy bike toys, and your enjoyment of those fancy bike toys is not more important than another person’s safety.

If I can’t wear my bike-shoes when commuting, when can I wear them?

I don’t know! Maybe when you’re on the Tour de France!

I know you take this bike stuff very seriously, but fancy bike shoes that attach to fancy bike pedals are specialty athletic equipment, and their place is in a serious bike race (one where the police have blocked off the streets), or on a bike path, or basically anywhere that your enjoyment of that specialised athletic equipment doesn’t interfere with other people’s safety.

To sum up

Bicycles should not be on the sidewalk.

Get off your bike and walk with it.

Why the PQ and its Charter of Values is racist

On a couple occasions, I have been challenged by people who are upset when I say that the Parti Québecois and its Charter of Values are racist. While I disagree, I can understand their objection. On the surface, the Charter of Values makes no reference to race, and there are even non-white members of the PQ, so it might be hard to see how I make the case for racism.

Before I directly address the problem of racism in the PQ and the Charter of Values, there are two fairly non-controversial general propositions about oppressive systems like racism that I will briefly outline. Understanding these positions will clarify why I say that the PQ and the Charter are racist.

1. You don’t need to have a negative disposition toward a group to be party to that group’s oppression

One of the most self-centred conceits of us white people regarding racism is the idea that it primarily exists as a state of mind for the white person—as if the biggest problem about racism is that it’s a character flaw for white people. (Mutatis mutandis for men and sexism, straights and homophobia, cis people and transphobia, etc.)

I see a parallel to this all the time when I implicitly or explicitly call out a straight person for something homophobic, and suddenly the biggest problem is that the straight person is offended at being thought a homophobe, not that something genuinely hurtful and oppressive happened to a queer person.

A society can be substantially sexist, racist, homophobic, transphobic, etc. in which its citizens have a generally positive attitude toward women, people of colour, gays, and trans people.

This is because racism, etc. are systemic and institutional ways in which a society is structured to make life worse for the oppressed group, while maintaining privilege for that group’s complement. Racism, etc. are not primarily a matter of personal dislike between two individuals, although that is unfortunately also part of it.

For emphasis, even if every single person in Canada had a personal epiphany, repented and swore to never have a negative thought about any other person on the basis of her race, that would not affect the problem of racism in Canada in the slightest until we dealt with the laws, power structures, social norms, institutions, and systems set in place to privilege us white people and make life harder for everyone else. Same thing goes for any other system of oppression (sexism, homophobia, transphobia, etc.).

Thus, appealing to the character or the intentions of a person or group (E.g. “They’re not racist! They don’t hate brown people because …”) is not a good argument against someone being racist, since racism is not primarily a matter of the state of mind of the group that is doing the oppression.

2. Even if a proposed piece of legislation doesn’t mention an oppressed group at all, it doesn’t mean that it isn’t oppressive to that group

Let’s do a thought experiment. Imagine there’s a group of legislators who propose a law, ostensibly to prevent voter fraud. Here is the proposed law in our thought experiment:

Everyone who wants to vote in Canada must bring a current government-issued photo ID and their birth certificate, and the names on the two documents must match each other exactly.

It is not hard to see why a law like this is sexist. (“But how can it be sexist? It doesn’t even mention women!”) It’s sexist because (except in Québec) it is common for women to change their names when they get married. Hence, such a law would systematically disenfranchise women more than men.

The important thing about this argument is that the oppressiveness of the law doesn’t turn on whether women are explicitly mentioned or whether the legislators had any hateful emotions toward women. The oppressiveness of the law toward women isn’t a function of the state of mind of the legislators at all. The only question that is relevant with regard to whether the law is sexist is whether or not it systematically makes life worse for women and not for men.

If you concede that a law like the one above is fairly clearly sexist, then it’s not a big cognitive jump to see why “Stand Your Ground” laws in the United States, for example, or even the Charter of Values here in Québec are racist. These are laws that systematically single out particular racial groups and not others, to make life worse for them. “Stand Your Ground” is racist because white people in the United States are overwhelmingly using it to murder people of colour. The Charter of Values is racist because we are using it to make life worse for people of colour.

It’s true that race is not mentioned in the Charter, but it is conspicuously silent on the subject, just like how there was no mention of women in the law in our thought experiment that if enacted, would disenfranchise most women. Even the prohibition on wearing very large and ostentatious crucifixes comes across as a transparent attempt to preempt accusations of racism. I grew up among very conservative Christians, and never once met a person who wore a large cross. Ever. I’ve never even heard of that happening among the most devout. I’m sure that the only reason that large Christian symbols were even mentioned is so that the PQ can say, “See? We’re not racist. The law will even apply to whites!” It certainly wasn’t included because there’s a problem with Christians wearing too many big crosses, threatening the neutrality of the state.

The Charter would not change life at all for white religious people. They already wear clothing that conforms to the Charter’s requirements. On the other hand, the Charter will cause crises of faith for many non-white religious people, make them feel unwelcome in Québec, and remove any representation they would have otherwise had in positions of authority in the province. The fact that this prohibition is invoked under the banner of “neutrality” is laughable.

So even though there is no mention of race, the Charter is racist because it systematically targets POC to take away their freedom and make their lives worse.

A response to the hatred from the TDSB: Pride should be offensive

Pride is a political protest, not just a big party

Whatever else Pride is, it’s a political protest highlighting the ongoing plight of sexual and gender minorities. Sure, it’s also a parade, a big party, a chance for gay guys to put on their most revealing clothes and hook up with other gay guys, but at its core, Pride is about the dignity and rights of sexual and gender minorities, which are still a hated and vulnerable group in Canada.

Events like Pride are important because Canada is a country where people who live outside the sexual / gender mainstream are regularly the object of abuse ranging from actual physical life-threatening violence to institutional and systemic discrimination and all the way down to daily micro-aggressions. Straight people often don’t realise that this still happens (“But we have gay marriage in Canada!”), or even worse, they sometimes try to paint themselves as the ones being oppressed. Being able to deny that this hatred exists is just one more privilege of being straight. Don’t forget: less than a month ago, the mayor of Toronto himself was doing his darnedest to keep the rainbow flag off city hall while the Olympics were being held in a country where non-straights are persecuted openly and explicitly.

This is why Pride is not just an exercise in frivolity and licentiousness. It is an important political movement. We haven’t “made it” yet.

The true meaning of Christmas Pride

Pride, figure 1
Pride, figure 1

The point of Pride is emphatically not that non-straight people are just like straight people, and therefore they deserve to have equal rights and be treated with equal dignity. That is the opposite of what Pride is for. If that were the goal, it would be called the “Gay Integration Festival” or something like that. Instead, it is called “Pride,” as in “I’m proud of the fact that I’m different from the sexual / gender mainstream, and I don’t need to deny who I am or assimilate to the mainstream in order to be valuable.”

The point of Pride is to emphasize the fact that there are sexual and gender minorities that are different in a lot of ways, and even though you may be offended by the fact that there are people who are different from you, non-straight people are still human beings with rights and you still have to treat them like human beings—with a certain amount of respect and dignity.

Thus, prominently featuring drag queens, sexual fetishes, strippers, and people in various states of undress is a political statement. The fact that it is offensive to the mainstream is a part of that statement.

This means that the (semi) nudity at Pride is not gratuitous in the slightest. If you want gratuitous (semi) nudity, watch the newest Star Trek film. (That’s right. I said it. The varying degrees of undress in most mainstream films is less defensible than the varying degrees of undress at Pride. Put that in your pipe and smoke it, conservatives.)

“The gays would get their message across better if they cleaned themselves up a bit”

CBC comments
CBC comments

You hear this from ostensibly well-meaning “allies” or even from gay people themselves—the argument that straight people would be more likely to accept non-straight people if they were less flamboyant, or if they were less in-your-face about it.

What’s scary about hearing this sort of thing from straight people is that they don’t even see how utterly dehumanising it is to make their acceptance of us as humans conditional on us “cleaning ourselves up.” As if our benevolent straight overlords get to choose who is treated with dignity and endowed with human rights and who isn’t on the basis of how they perceive us. And of course, if we don’t act the part, they get to revoke those privileges. That is exactly the opposite of what Pride is about, and suggesting that Pride be “cleaned up” and made “family friendly” totally misses the point of the whole political movement.

To ask for a Pride that’s had all the offensive, lewd and sexual parts removed would be like asking a labour union that’s on strike not to mention the terrible wages or the unsafe working conditions.

To ask for a Pride parade that’s just a bunch of cute monogamous gay and lesbians couples holding their adopted children is to even further marginalise all the other sexual and gender minorities. What could be more cruel than telling someone who’s a minority within a minority that the festival that’s supposed to be celebrating his/her differences is embarrassed by him/her?

It’s even more disheartening to hear the “Pride should be cleaned up” line from gay people.

Maybe you would be okay if it were a “gay integration festival” rather than Pride. Maybe you want to find your masc-for-masc gay guy (no fems!), get married, buy a house in the suburbs, wear sweater-vests, adopt a kid and enjoy all the straight privilege that you can. (“You’re gay, but you’re just like one of the guys, you know?”) If you want that, go and do that. I sincerely hope the life you choose is fulfilling and happy.

But don’t you dare try to co-opt a political movement for your own narrow ends when its goals are broader than just extending straight privilege to those who “clean up well.”

“Won’t someone please think of the children”

The bigots on the TDSB have framed their objection to Pride in terms of upholding the laws regarding nudity and protecting children. How pious of them. (Have you ever noticed that in debates touching on sexual morality, there’s always someone who cries out, “Won’t someone please think of the children!” By the way, the answer to that style of argument is almost always: “We are thinking of the children, and some of those children happen to grow up to be the people that you’re demonizing.”)

Their argument is that if a person were to be naked in public in any other context, she would be breaking the law regarding public nudity. This may of course be true, but the fact remains, we’re not talking about any other context. We’re talking about Pride. I would presume there’s also a law against driving a truck down the middle of a street at 5 km/h carrying an extra-wide load with dancers on it, but we make an exception in the case of the Pride parade, because we all agree that allowing this kind of political expression is more important than always slavishly enforcing this (otherwise valid) traffic law.

The reason for a law against public nudity is presumably to protect vulnerable people from aggressors who might use nudity to threaten them. Nobody wants to live in a place where some creeper can make you feel unsafe by following you around and then flashing you from underneath his trench-coat on the métro. I’m not suggesting that the public nudity law needs changing.

That said, we should realise that the reason for the law against public nudity is not to stifle valid political expression. (Sorry, TDSB!) The lewd and offensive nature of Pride is not gratuitous and incidental. It is an essential part of the core message, and frankly, anyone who comes to Pride should know beforehand to expect to see some skin.

The right of non-straights to protest ongoing hatred, discrimination, intimidation, bullying and violence against sexual and gender minorities is more important than the right of a few prudes not to get offended by seeing the human anatomy while attending the Pride parade.

And if by chance there’s a certain someone from the TDSB reading this, say a homophobic trustee who thinks that he can hide his hatred and bigotry under the holier-than-thou camouflage of respect for the law, I want you to know—from the bottom of my heart—that you can go suck a bag of dicks.

Don’t make life harder for sex workers—make it illegal to discriminate against them for employment and education

The Supreme Court of Canada has recently struck down the laws regarding prostitution, saying that they were putting sex workers in danger. The reasoning behind the court’s judgement was to make life easier and safer for a group that is often hated and is definitely vulnerable. Rather than heeding the clear spirit of the decision, some have taken this as an opportunity to find other ways to be cruel, judgemental and to try to bring about harm or make sex workers unwelcome in their communities.

The most repugnant part of all this is that many of those who most vehemently argue for tougher restrictions—laws to make life even harder for sex workers—these people do it out of a misguided sense of moral superiority. As if it weren’t hard enough to do sex work. As if there were something admirable about stacking the deck against them.

Due to the judgement, the government has one year to pass new legislation on the subject. In an uncharacteristically democratic move on the part of the Harper government, Ottawa has asked for public input on the subject.

Some (terrible) options that have been proposed

The Ministry of Justice website lists a few options for new legislation (see Table 1), one of which is prohibition. The government may decide to pass a law banning sex work in Canada. This will make it illegal to buy sex and to sell it. Under such a law, sex workers would become criminals.

I would like to point out the obvious. A law like this cannot make prostitution go away. This will only push sex workers further out to the margins of our society and reinforce a cycle of violence and exploitation against them. If you advocate for a position like this, you are not advocating for the non-existence of prostitution. You are just advocating for the destruction of the lives of a hated and vulnerable group of people. If you care about the well-being of others at all, you can’t endorse such a position.

Another option is “abolition,” or the so-called “Nordic model.” This would make the purchasing of sex illegal, but keep the selling of sex legal. Under this kind of a law, anyone who buys sex would be a criminal, but it would be perfectly legal for the sex workers to provide it.

Again, let’s not kid ourselves. A law cannot make prostitution go away. While this option will mercifully keep sex workers out of jail, it’s not exactly a huge step toward making life easier and safer for them, and it will keep them and their work at the margins of our society, away from the benefits and privileges of the mainstream, which the rest of us enjoy. If you can’t see how this kind of law can only continue to marginalise and generally perpetuate violence against sex workers, I don’t think I can explain it to you.

Here’s a better idea

Let’s imagine for a moment that we, as a society, were actually serious about helping sex workers. This is clearly the spirit of the Supreme Court decision, at least. If we wanted to help sex workers, and not just in the paternalistic “I’m helping them by giving them a good incentive to stop being a whore” sense of the word, we could use this opportunity to refine the law in such a way that it gives them some options. For example, we could make it really easy for people to get out of sex work.

Here’s my idea: Pass a law making it illegal in the context of education or employment to discriminate against a person on the basis of a past work history that includes sex work, stripping, porn acting, etc.

I’m not so naïve to think that this will suddenly end all the subtle ways in which a history of sex work can make it difficult for someone to get or keep a job, or to enrol in school or stay in school. But at the very least, we can eliminate the obvious ones. It’s kind of like how we have laws to say that you can’t reject job applications from gays, women or people of colour because they are gay, women or people of colour. It doesn’t eliminate homophobia, sexism, or racism, but I wouldn’t want to live in a country that didn’t have such laws.

Most of the people reading my blog are pretty privileged, so you may not understand this, but not everyone can afford not to be a sex worker (or a stripper or a porn actor). Why on earth should anyone have to worry about being expelled from her school or not being able to get a job later in life for doing what she has to do to make ends meet?

Not only that, but some people choose to do sex work, and not out of dire financial need, and it’s not the place of the government of Canada to enforce Christian sexual values on everyone who lives here. So if your major hang-up regarding the endorsement of something that isn’t a total ban on prostitution is religiously motivated, that is not a reason to make it into a law for everyone else. It may be a fine motivation for your own decisions and actions, but the enforcement of your private religious beliefs would be an abuse of the power of the state.

In the end, it comes down to what we think this law is supposed to do. Is our highest priority that we use the machinery of the state to punish those who deviate from Christian sexual norms, or is our highest priority that every single person in Canada (whether they share the same sexual morality or not) is safe, and has a fair shot at a good life?

The obvious objection—”won’t somebody please think of the children”

I can hear the obvious objection coming from the conservatives out there—why should we want to make like easier for prostitutes? If being a prostitute or a stripper or a porn actor isn’t something that will follow my daughter around for the rest of her life, what can I tell her to dissuade her from becoming a sex worker?

I have two answers to that.

First, that line isn’t what’s keeping people from going into sex work.

Second, if it is your daughter who ends up in sex work, you will want the government to help her get out of it, and a law against discriminating against her on the basis of her sex work history will help.

If you want us to “think about the children,” then let’s also spare some time to think about the children who end up as prostitutes too.

Table 1: The options for new prostitution legislation, according to the Ministry of Justice

Selling sex legal Selling sex illegal
Buying sex legal What we had in Canada up until the Supreme Court decision* Even the Tories knew better than to suggest this
Buying sex illegal The “Nordic model” or “abolition” “Prohibition” or the “American model”

* With some restrictions. E.g. “living off the avails” of prostitution was illegal.

If I were the philosopher-king of the world

  • All measurements would be metric, even in America. This would include recipes. (“T” is different from “t”? Why?)
  • The 12-hour clock would be abolished in favour of a 24-hour clock.
  • Time zones would be abolished. Every clock would be set to GMT, Beijing time, I don’t care, just make it consistent.
  • Dates would be written in compliance with ISO 8601.
  • Daylight savings time would be abolished.
  • The calendar would be reformed to something that makes sense.
  • Academic references and style guidelines would be standardised across all disciplines and publications once and for all. Academic citations would be hyperlinked in all electronic versions.
  • Usernames and passwords would be gone forever.
  • AAA batteries would be illegal
  • DRM would be illegal, and for that matter, copyright / patent law would be a very different thing.
    • Maybe copyright on a creative work would last 28 years only, with no extensions? (Ahem, Disney.)
  • There would be a universal maximum wage, indexed to a universal minimum wage, and a guaranteed basic income.
  • The laws regarding royal succession for Canada would be changed such that the queen of Canada is chosen by random lottery among Canadian citizens.

I have opinions.

Lessons for Québec from British pop singers and Japanese Anime: “secular” is not “neutral”

The Québec charter of values

Over the last few months, much debate has occurred over the proposed Québec Charter of Values, which was ostensibly introduced in order to guarantee the “neutrality of the state.” The real reason, of course, is that the PQ wants to gain political points with its separatist base, and has no qualms about riding roughshod over the rights of minorities to do so.

That said, I still want to address the “neutrality” thing, because it bothers me so much when I see people making the claim that the Charter will make the machinery of the state more “neutral.” But first, let’s consider a couple related questions.

Why do British people lose their accents while singing?

Have you ever heard a person ask, “Why do British people sound American when they sing?”

The reason for this phenomenon is not that British people actually sound American when they sing. For that matter, if you think about it, American people don’t sound particularly American when they sing either. Because of the mechanics of singing, everyone has to pronounce their words in more-or-less the same way, regardless of their speaking accent.

While speaking, one’s accent might influence what syllables to stress and whether to use a short or a long vowel sound for particular words. When singing on the other hand, pretty much all of that is dictated by the music itself. There is really only one way to sing “Ave Maria,” for example, no matter what your accent is. And so, everyone sings the same way, and it’s not the same as anyone’s speaking accent.

Don’t believe me? Read the words, “Ave Maria” in your own head in different kinds of accents—standard BBC, Zoidberg, Morgan Freeman, etc., and then imagine those same people singing it. Unless you’re imagining them really exaggerating their accent, they all have to sing it in pretty much the same way, just due to the nature of what singing is.

Why are Japanese Anime characters drawn as white people?

Curiously, this is the same thing that happens when a person asks, “Why are Japanese Anime characters drawn as white people?

They’re not. Read the linked article. Japanese Anime characters are drawn as cartoon characters. They are not photo-realistic representations, and it is only the assumption of American viewers that fills in the gaps in favour of these characters being white. It’s the same reason that when you draw a stick figure, you assume it’s a white male, unless it has a dress or a something to mark the “other.”

What’s going on in these cases?

The underlying assumption in both of these questions is the same fallacy. The assumption is that the majority (in these cases, white and American) is “neutral,” “default,” “normal.” In the absence of all markers to the otherwise in one’s singing voice or in cartoon characters, many people will fill in those gaps with what they take to be “neutral,” and come to the conclusion that British singers all sing with an American accent, or that Japanese Anime characters are drawn as white people.

A similar fallacy is being made by supporters of the proposed Québec Charter of Values. Like the cases above, they assume that what they are (i.e. non-religious, or maybe non-visibly Christian) is the “default,” but in this case, instead of inadvertently filling in something that’s neutral with details from what they take to be the default, they are explicitly trying to make an ideal “neutral” person, based on their own assumption of what the “default” is, or should be.

Challenging the assumption—”secular” is not “neutral”

I have heard so many politicians indicate their support for the Charter because it’s supposed to make the state more “neutral.” There is no reason why not-wearing-a-head-covering is “neutral.” In fact, I’m here to tell you that there is no a “neutral” to be found.

There is no normal, neutral, or “default” type of person when you’re thinking along categories like gender, sex, race, religion, orientation, etc. And as far as religions go, an atheist person is not a person who has no religious beliefs. It’s that her belief is that there’s no God. To repeat: there is no “default.”

What would neutrality actually look like?

Imagine a little boy in Québec who grows up in a family where head coverings are the norm. He looks at his doctors and teachers, and none of them looks like him. He has a minor run-in with the police in his teens, who call him “towel-head,” and slowly, over time, he realises that there is no one—not a single person—in a position of power in his province who looks like him. His Christians friends, on the other hand, have all kinds of role models—teachers, doctors, judges, lawyers—all employees of the state who look just like them.

How is that neutral?

If something is supposed to be neutral, it has to be neutral for everyone, not just for the majority.

By saying that a public worker has to remove her head-coverings in order to be “neutral,” we are saying that a certain group of people, namely the non-religious and the Christians, are more “neutral” than the rest.

The test that the PQ seems to be applying for whether a government employee appears to be neutral is this: If a white, Christian person looked at a government employee, would that person worry that she was going to be treated by the government employee differently because the employee is religious?

If your major concern is protecting white Christians and non-religious people from anyone who wears a head-covering, of course the answer is to say that a “neutral” state is one where everyone conforms to the standards of dress for Christians and the non-religious. But really, we should stop calling it “neutrality” in favour of a more honest term like “state enforced atheism or Christianity.”

I suggest another test for the neutrality of government employees. Something like this: If a non-white, non-Christian, non-secular, totally marginalised minority person looked at our government employees, would that person worry that she was going to be treated like an “other”?

If a child growing up in Québec sees a number of people wearing head coverings in government jobs that is proportional to the number of people wearing head coverings in the general population, that would be true neutrality.

CBC’s “Dr C” and the problem of doctor-centred care

A CBC-hosted blog has been following the story of “Dr C.” CBC describes him as “a St. John’s physician training in internal medicine. He’s also a writer, and he’s documenting his life since being diagnosed with cancer.” His blog posts show up on the CBC Health twitter account periodically, and they pass through my newsreader on a fairly regular basis.

For the last few months, I felt uncomfortable every time I saw one of his blog posts go by, and I couldn’t put my finger on why that might be. I think today I can finally articulate my misgivings.

A doctor’s privilege

I feel like the underlying assumption for CBC’s intense coverage, and the voice that “Dr C” has in expressing his experience with cancer is that when it’s a doctor who is diagnosed with cancer, he will have some interesting insights on the matter. In fact that’s the whole premiss of the “Dr C” blog. This makes me uncomfortable because in the modern medical system, a doctor’s voice is always the most important.

Fortunately, this is less the case than it used to be, to be sure. It used to be that nurses were trained to stand up out of respect when a doctor entered a hospital room, for example. But even today in 2014, the opinion of a doctor is, on the last analysis, the only one that really matters in the healthcare system, and in a lot of ways, that shouldn’t be the case.

What is patient-centred care?

Before a conspiracy theorist mistakes what I’m writing about, I want to clarify that I’m not saying that an untrained quack should be given the same voice as a medical doctor on issues like vaccine safety, or the efficacy of “alternative” medical therapies. I’m not advocating for that at all. I’m fully on the side of medical science, and I have rather mainstream views on that matter, even though I work in the Medical Ethics Unit. (It turns out that the real evils of drug development and medical practice are rather mundane things, mostly done under the light of peer-reviewed scrutiny. Go figure.)

What I’m talking about is patient-centred healthcare, a concept that most medical professionals agree on, or at least pay lip-service to. It is a somewhat nebulous umbrella concept, and it is aspirational in nature—a healthcare worker can always try to be more patient-centred.

The idea itself is not controversial. Every healthcare worker would likely say that she wants to be patient-centred, and this includes things like catering her care toward the patient’s own idiosyncratic values, taking into account the patient’s strengths, and seeing the patient’s family as the unit of care, rather than maintaining the fiction that it is possible to treat a disease process in an individual without regard for the rest of the patient’s life.

So what’s the problem with Dr C’s blog?

I have nothing against “Dr C” from the CBC. I think it’s terrible that he (or anyone) has cancer, and I wish him the best in his treatment and recovery. I’m even glad that his blog has given him a place to work through his thoughts. I hope that he’s a more sympathetic physician as a result, and that his insights have helped other people to deal with their own cancer diagnoses.

That said, I feel like the way in which a doctor’s opinions are privileged in any discussion on healthcare is very troubling, and I can’t shake the feeling that this blog pushes it even one step further. It’s as if they’re saying that privileging a doctor’s voice when he’s the one treating the cancer isn’t enough. We also have to get a doctor to tell us what it’s like to be a patient as well, because then it will be something worth listening to.

Collected #XmasTips to help you Christmas better next year

I'm ever so good at Christmas!
I’m ever so good at Christmas!

I keep getting fan-mail from people asking me how it is that I’m so good at Christmas. I can’t give away all my secrets, but this year I’ve made a conscious effort to tweet when I have a good holiday tip that other people can use to make this terrible season a little bit better.

  • Buy a Christmas tree that branches into two at the top. That way, you can put an angel on one branch and a devil on the other. (Dec 8)
  • When a Christmas song includes “fa la la la la,” that means the original lyrics were censored. Add your own obscenities back in! (Dec 9)
  • Tired of Christmas already? Get in a fight with family now and cancel it—then, take the money and have 2 Christmases next year! (Dec 11)
  • Wrapping up a gift of a pair of mittens in an old iPad or MacBook box is an economical way to spice up your gift-giving! (Dec 11)
  • Next year, Christmas falls on Friday the 13th—tell your friends and family about it now, before you think it through very clearly! (Dec 13)
  • Nephew asking for a new PS4? Wrap up an old PS2 and give it to them with instructions to play it twice! (Dec 18)
  • Express strong disapproval of anyone who doesn’t like Christmas! Nothing says “holiday spirit” like stifling dissent. (Dec 21)
  • Unwelcome holiday houseguest? Play on repeat and discuss the homoerotic potential of the Michael Bublé version of “Santa Baby!” (Dec 22)
  • Need a costume for your Christmas party? Nothing says “Christmas” like “pregnant out of wedlock!” (Dec 23)
  • Hurry and clean up as fast as you can before they arrive or your family won’t love you as much! (Dec 23)
  • Mass infanticide, although part of the Christmas story, is best left to fantasy only. (Dec 24)

Of course, by the time this post is published it will be too late for you to abort your impending holiday failure, but if you heed my suggestions next year, you may also be able to Christmas like a pro and win the respect and adulation of your peers and familial relations!

Why I dumped Gmail

Reason one: I need my email to work, whether I follow the rules on Google Plus or not

Google has linked so many different products with so many different sets of rules to the same account that I feel like I can’t possibly know when I am breaking some of its terms of use. And I’m not even talking about specifically malicious activity, like using software to scrape information from a Google app or a DDoS attack. I mean something as basic as using a pseudonym on Google Plus, or a teenager revealing that she lied about her age when signing-up for her Gmail account. (These are both things that have brought about the deletion of a Google account, including Gmail.)

For starters, I think it is a dangerous and insensitive policy to require all users to use their real names on the Internet, but putting that aside, I don’t want to risk having all my emails deleted and being unable to contact anyone because of some Murph / Benjamin confusion on Google Plus.

Reason two: it’s actually not okay for Google to read my email

Google never made it a secret that they read everyone’s email. Do you remember when you first started seeing the targeted ads in your Gmail? I bet you called a friend over to look. “Look at this,” you said, “we were just talking about getting sushi tonight, and now there’s an ad for Montréal Sushi in my mailbox! That’s so creepy,” you said.

And then you both laughed. Maybe you made a joke about 1984. Over time, you got comfortable with the fact that Google wasn’t even hiding the fact that they read your mail. Or maybe you never really made the connexion between the ads and the content of your email. Maybe you thought, “I have nothing to hide,” and shrugged it off, or did some mental calculation that the convenience of your Gmail was worth the invasion of privacy.

I guess over time I changed my mind about being okay with it.

And no, this isn’t because I have some huge terrible secret, or because I’m a criminal or anything like that. I just don’t want to send the message that I’m okay with this sort of invasion of privacy anymore. Google’s unspoken challenge to anyone who questions their targeted ads scheme has always been, This the price you pay for a free service like Gmail. If you don’t like it, you can leave.

This is me saying, I don’t like it. I’m leaving.

Reason three: Gmail isn’t even that good anymore

When I signed up for Gmail, there were three things that set it apart:

  1. Tag and archive emails—forget folders!
  2. 10 gigabytes of space—never delete an email again!
  3. Web-based interface—access it from anywhere!

I’ll deal with each of these in turn.

1. Tagging was fun, but it only really works in the Gmail web interface, or in an app specifically designed for use with Gmail. Unfortunately, Gmail just doesn’t play nicely with other email apps, like the one in Mac OS X, or Mail on the iPhone or the BlackBerry. You could make it work through IMAP, having it tell your mail client that each tag was a folder, but it was always a bit screwy, and I never figured out how to put something in two tags through a 3rd-party app or mobile device.

The value of being able to organise emails by simultaneously having them in two categories is outweighed by the fact that I couldn’t access this functionality except through the browser.

2. The amount of space that Gmail provides for emails is not very much these days. I have a website (you may have guessed) and it comes with unlimited disc space for web hosting and emails. 10 gigabytes is just not that big a deal anymore.

3. I can do this with my self-hosted email as well, and I don’t have to suffer through an interface change (“upgrade”) just because Google says so.

So what’s the alternative?

Full disclosure: I haven’t shut down my Google account. I’m forwarding my Gmail to my self-hosted email account, so people who had my old Gmail account can still contact me there for the foreseeable future. I am also still using a number of other Google products, like the Calendar and Google Plus, but my life would not go down in flames quite so quickly if those stopped working as compared to a loss of email access.

Basically, I am moving as many “mission critical” aspects of my life away from Google as I can, to keep my technological eggs in a few more baskets. Email, for example, will be handled by my web host, of which I make backups on a regular basis.

I’m not trying to go cold-turkey on Google. I’m just not going to pretend to be as comfortable as I used to be as a guest on Google’s servers.

Update (2013 Nov 18)

I switched back to the Thunderbird email client a couple weeks ago. It supports tagging and archiving, just like Gmail.

Update (2018)

I switched to Protonmail!