The issue of MMR vaccination and its alleged side effects has been raised again after one of the authors of a study linking a particular bowel disease and autism has written to the Lancet arguing that we are at risk of a major measles epidemic because of a lack of take up of the MMR vaccine.
Dr [Simon] Murch, of the centre for paediatric gastroenterology at the Royal Free Hospital in London, was one of the authors of a 1998 paper published in the Lancet which looked [at] the connection between inflammatory bowel disease and autistic disorders.
The paper found a connection between bowel problems and autism but did not conclude that MMR was connected to this.
In his letter Dr Murch says:
"An unprotected child is not only at personal danger, but represents a potential hazard to others, including unborn children. Unless vaccine uptake improves rapidly, major measles epidemics are likely in the UK this winter."
I've tried to get my head around the issue by looking logically at the comparative risks but I'm afraid I can't. It seems to me that medical risk is always difficult to measure and explain since we are dealing with moral judgements as much as risk assessment.
Suppose I have a new drug which will cure 10,000 sufferers of a particular chronic condition every year. I also know that there will be adverse reactions and a certain number of people will die each year who without the drug would have lived, albeit with a reduced quality of life because of their original ailment.
How many deaths are 'acceptable' before the drug should be withdrawn? Is this purely a matter of risk assessment?
[I recall one anti-inflammatory drug was withdrawn because of a few cases of adverse reactions, even though it had been shown to be highly effective in treating arthritis. The problem is that the people suffering the adverse reaction (in this case death which is pretty adverse) are not the people whose risk of other events is reduced. I can't give a URL link because I can't recall the name of the drug.]
These are the issues underpinning the MMR debate. For the parent of a child due for vaccination, this isn't a theoretical question, it is intensely personal and they believe that their child's life hangs on the decision they take. As a parent I faced similar concerns when considering vaccination for whooping cough. Similar vaccine damage stories were circulating about that vaccine. We decided to go ahead because the incidence of whooping cough was rising and the increased risk from the disease appeared to outweigh the perceived risk from the vaccine.
The problem is that measles is seen by many as a relatively trivial childhood disease - one of the tribulations of childhood. Of course it isn't but we reach that judgement in a context where the other threats to our children have reduced - we no longer need to worry about cholera, diptheria, polio. Our assessment of the risk is not just a numbers game.
This is from the discussion forum on RedPaper. You will have to register to read the context, but it seemed such a good demonstration of the value of the arts to all of us, not jus the critics and others who make a living from it, that I asked the writer for his permission to post it here.
I can recite many poems by various poets off the top of my head. I have sonnet 18 by Shakespeare crammed away somewhere between my ears. I used to work in a bikini store down in the Keys (I loved that job). The manager was moving away and was training me for the position. she used to have to bring her 3 year old daughter, Savannah, in with her sometimes as she couldn't afford a baby sitter and her husband worked long hours out on the fishing boats. One day we had little business and I was entertaining the little girl while her mother did the books. I decided to start reciting Shakespeare to her....
"Shall I compare thee to a summer's day?"
"Thou art more lovely and more temperate:
Rough winds do shake the darling buds of May,
And summer's lease hath all too short a date:
Sometime too hot the eye of heaven shines,
And often is his gold complexion dimm'd;
And every fair from fair sometime declines,
By chance, or nature's changing course untrimm'd;
But thy eternal summer shall not fade,
Nor lose possession of that fair thou ow'st;
Nor shall Death brag thou wander'st in his shade,
When in eternal lines to time thou grow'st:
So long as men can breathe, or eyes can see,
So long lives this, and this gives life to thee. "
I was in awe that this three year old had actually sat wide eyed and listened to me recite the whole poem. I was expecting to maybe get through three lines.
when I was done she ran over to her mother, threw her hands in the air like she was making a big circle and said "Mommy mommy, sometimes the sun comes out... and ... and... its big and pretty."
I recited some of my poetry to Savannah too, three lines in she was back to drawing on the back of the counter with a crayon.
Kurt Erhard Berger
On a recent visit to Birmingham I had the opportunity for a brief look at the new Bullring development and its flagship Selfridges store. I have to admit that despite my initial misgivings, based purely on TV and newspaper photographs, I was impressed. I didn't have time to explore the scheme from all angles, but it seems to work well as a piece of urban design, not just as a collection of flashy buildings.
Approaching the scheme from the station side, it looks pretty much like just another shopping centre, although that other iconic Birmingham building, the Rotunda is still prominent. A reasonable pedestrian link seems also to have been created to Smallbrook, which when I lived in Birmingham was a dual carriageway racetrack isolated from the main centre.
Inside the development are three levels of shopping - all busy when I was there. Every opportunity seems to have been taken to open this up so that views and horizons are constantly changing as you walk through. Also, contrary to what I expected the development isn't a single enclosed mall. Once inside it is very quickly possible to see daylight at the other end, again through a three storey glass wall. This leads out at the middle level to a new street, linking New Street and High Street to the area around St Martin's church, which was formerly separated by the inner ring road. Across this street is a further enclosed area but there are also shops taking access from the new pedestrian street.
It is from here that you get the first view of the new Selfridge store and it is pretty spectacular.
The levels in this area change quite rapidly and this has enabled the creation of a kind of viewing balcony above the new square around the church. Access to this lower level is also available from within the new development on both sides.
Overall then I think the development is a piece of world class urban design - it is a pity we never seem to get this standard of design in housing development .
Recycled, but good quality, office furniture can be delivered across the UK
by the Green-Works social enterprise (see news item below). Everything from
desks to chairs, filing cabinets to notice boards, coat stands to stationery
are provided by donor members for re-use at low cost by voluntary
organisations. See http://www.green-works.co.uk for more info.
From the VolResource newsletter. Subscribe by email to email@example.com.
As you may know, New Economics Foundation is leading for the Social Enterprise Partnership GB a major programme of work to help social enterprises prove and improve their quality and impact. Our needs analysis is guiding the interventions of the project. We want to keep learning, and so would like as many people as possible to review our findings and to comment upon them. The key findings document of the needs analysis is only 5 pages long, although for the enthusiasts there are a number of appendices. You can download the needs analysis from the bottom of our webpage at http://www.neweconomics.org/gen/newways_qualimpact.aspx
I'd be very grateful if you could circulate this to anyone in your networks that you think would be interested, and I look forward to receiving your comments.
Please send your comments to Hetan.Shah@neweconomics.org
For a variety of reasons the posting frequency is likely to drop over the next week or so. Any posts will probably just be links to interesting items rather than the more discursive appraoch I've fallen into.
Green Futures for September/October looks at the question of how far business should reflect moral values.
Efforts to raise the benchmark through corporate social responsibility (CSR) initiatives usually rely on making 'the business case' - in other words demonstrating that doing good is good business. However this carries an insidious message as Ian Christie points out .
But, over time it brings with it a damaging implication – that if it weren’t good business to do the right thing for social inclusion and the environment, we’d stop. The use of hardnosed language about the business case also subtly ‘puts ethics in their place’ – a subordinate one. This is unintended, but it has practical effects. It creates a sense that ‘philanthropic’ motivation is somehow old hat or inevitably inferior to tough-minded, business-case-based action.
Christie goes on...
One under-explored idea could be the foundation of a new approach from business to the case for CSR. It involves taking seriously the arguments of some schools of moral philosophy, about the existence of universal needs and rights that should be respected. When we know something to be the right course of action, the argument goes, what we mean is that we would wish it to be universally enacted.
The Just Values project, undertaken jointly by BT and Forum for the Future looks at the ethical case for companies engaging with the sustainable development agenda.
This all raises the question of the distinction if any between personal and corporate morality. If an action by an individual is judged not to be moral, how can that same action be acceptable when carried out by a business, simply on the basis that it would be unprofitable to do otherwise? The activities of that business are carried out by people to whom the moral strictures presumably apply.
I've posted before on the so called 24 hour city and on the issue of binge drinking. While I believe that the changes in the licensing laws contained in the Licensing Act 2003 are needed in their own right, it seems possible that the changes may lead to problems in our smaller towns without some creative thinking.
The main changes, which will affect all premises that sell or serve alcohol are;
* Transfer of responsibility for alcohol licensing to the local Council
* Introduction of a "Premises Licence"
* Introduction of a "Personal Licence"
* Relaxation of licensing hours permitting 24-hour sale of alcohol
* Development of a Council Licensing Policy
I'm only going to deal with the new responsibilities of local councils who now have to prepare a Licensing Policy. This must incorporate four 'licensing objectives':
* Prevention of crime and disorder
* Prevention of public nuisance
* Public safety
* Prevention of children from harm
The Council will have to grant a licence unless it conflicts with the Licensing Policy. It can impose conditions that promote the licensing objectives such as requiring door supervisors in a night club to promote the crime prevention objective, or noise control measures to prevent public nuisance.
The theory is that relaxation of the traditional hours of sale will prevent the accumulation of drinkers at closing time. My fear however is that the problem is not the hours but the drinkers. I'm attending a meeting tonight on some problems in the town centre of petty vandalism and drunken behaviour. It is critical to the enjoyment and growth of our town centres that we should be able to walk around them without fear of violence - or vomit. How far I wonder are local councils going to be willing to go in tackling these issues?
This Statement of Policy does not seek to undermine the right of any individual to apply under the terms of the Act for a variety of permissions and to have such an application considered on its individual merits. It does not seek to override the right of any person to make representations on an application or seek a review of a Licence or Certificate where provision has been made for them to do so in the Act.
I don't know what guidance has been issued by central government of course. It wouldn't be the first time that central government has introduced legislation and then been so frightened by the way it is taken up that they cripple it by 'advice' and guidance'