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[links] Link salad is the new black - Lakeshore — LiveJournal
An author of no particular popularity

Jay Lake
Date: 2011-03-09 03:56
Subject: [links] Link salad is the new black
Security: Public
Tags:books, culture, green, healthcare, links, mainspring, movies, personal, politics, process, publishing, religion, reviews, science
Book Review: Green by Jay Lake — A reader with some very mixed reactions.

A reader reacts to Mainspring — Very much not with the liking. Clearly I am not winning the Internets today.

Dice & Deadlines: Your Internet Presence — Advice for authors from editor Jennifer Brozek.

A Book By Any Other Name...Scrivener's Error with a 'prescription for publishing', including a number of trenchant observations about the current state of the industry. He also calls to mind my comment that a book is essentially a license rather than a product.

Nerds Try to Drive Studio to MadnessFans petition Universal to make Guillermo Del Toro's dream Lovecraft project. (Via Justin Steele.)

Vintage Infoporn — Some cool history of graphic visualization of data, from Infographics.

Printing a human kidney — A TED talk. (Via [info]lt260.)

Mont. judge orders hysterectomy, patient appeals — This is a challenging story. A wide array of peculiar behavior, ranging from the eccentric to the pathological, is privileged under the guise of religious belief in our society, but when that's where the question of competency hinges, it's a tough pass. If this were treatment being refused on behalf of a child, I would stand firmly against the parent's claim. But an adult refusing for themselves? Much tougher call. People really are entitled to go to hell in their own way, so long as they don't take others with them.

The Forbes 400 vs. Everyone Else — In case you were wondering where the money went.

?otD: Visigoth or invisigoth?



3/9/2011
Writing time yesterday: 1.25 hours (2,500 words on Sunspin)
Body movement: 30 minute suburban walk (trailhead was closed)
Hours slept: 6.25 hours (interrupted)
Weight: n/a
Currently reading: The Falling Machine: A Society of Steam Novel by Andrew P. Mayer

Post A Comment | 16 Comments | | Link






jtdiii
User: jtdiii
Date: 2011-03-09 12:06 (UTC)
Subject: (no subject)
Speaking of Mainspring, I recently loaned my mom the tree books in that set. She had been asking about your writing.
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Jay Lake: writing-Mainspring
User: jaylake
Date: 2011-03-09 12:23 (UTC)
Subject: (no subject)
Keyword:writing-Mainspring
I hope she enjoys! And give her my regards.
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jtdiii
User: jtdiii
Date: 2011-03-09 12:28 (UTC)
Subject: (no subject)
Certainly, I introduced her to your blog and she enjoys reading it. She remembers you fondly.
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cathshaffer
User: cathshaffer
Date: 2011-03-09 13:32 (UTC)
Subject: (no subject)
Well, there's no religious teaching that a woman can't have a hysterectomy if she has cancer. In fact, under Catholic doctrine, a hysterectomy would be allowable in that situation even if she was pregnant. Some other traditions may be more strict, but I don't know of any that disallow hysterectomies for non-pregnant women with cancer, per se. (Jehovah's witnesses will not take transfusions, but if she were JW, I think it would have been mentioned.)

So that leaves two possibilities. The woman's "deeply held religious beliefs" are either delusional or they come from personal revelation. Personal revelation is deeply shaky, and I'm not sure it's constitutionally protected. In any case, she's been examined by a psychiatrist, and a number of her other health care providers have written to the court saying that she is delusional, so I think the weight of evidence is on the delusional side. I have also had the experience of being thanked for making tough decisions against the "will" of a delusional mind, once that person had been stabilized, and been told how frightening it was to be in the grip of the voices, knowing that the compulsion to obey could lead to death. Our legal system all too often gives rights to a disease at the expense of the human being inside.

You can walk out of a cancer appointment any day of the week without accepting treatment. People do it all of the time. I don't think the health care team would have gone out of their way like this unless they believed that it is what she would want if she were mentally stable.

Because my mother has religious delusions, I'm very familiar with how convincing they can be, and how they can play into people's religious narrative about how God is guiding and directing their lives. It is unfortunate that the privileging of religious narrative in our culture interferes with access to treatment for people who are mentally ill and happen to have delusions of a religious nature. I have a feeling if Allah was ordering her not to have a hysterectomy to save her life, she wouldn't have been taken seriously.
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mlerules: Brain
User: mlerules
Date: 2011-03-09 15:35 (UTC)
Subject: (no subject)
Keyword:Brain
Seems to me that regardless of the religious belief vs. wackiness concerns, there's still the issue of privacy and one's right to choose what to do/have done to one's body.
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cathshaffer
User: cathshaffer
Date: 2011-03-09 15:42 (UTC)
Subject: (no subject)
Not if you are legally incompetent to make your own decisions. Our system of law allows for others to make that decision in their own best interests if they meet the legal criteria for being incompetent. That law allows us to take care of old people with Alzheimer's, young children, mentally ill people, developmentally disabled people, people with traumatic brain injury and others who are not able to care for themselves. The question is whether, if a person's incompetence comes packaged with religious claims, we ought to give greater credence to the religious claims. I think not.
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Renee Babcock
User: renegade500
Date: 2011-03-09 18:44 (UTC)
Subject: (no subject)
It seems to me (based on reading that article) that the only reason this woman was considered by the psychiatrist to be incompetent was because of her religious beliefs. I would wonder how much time the psychiatrist spent with the patient before making their determination? How do we know the doctors own views on religion didn't play a role in his determination? If she's having delusions, in his medical opinion, what kinds of psychotropic drugs does he have her on, what therapies has he recommended for her? Or, did he just make a determination and then move on to the next case?

It seems to me that if the woman said she understood she had cancer and could die without treatment that she's got enough mental capacity to make the decision for herself. And frankly, it's her right as an adult to make that decision, and is not the business of courts or doctors to co-opt that decision just because they don't agree with it.
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cathshaffer
User: cathshaffer
Date: 2011-03-09 18:55 (UTC)
Subject: (no subject)
No, a psychiatrist has to do a full evaluation on a person in order to deem them incompetent.

Your opinion about competency reflects a common misunderstanding that if people understand cause and effect, they must not be insane. In reality, people can experience powerful compulsions to do things that the really don't want to do and would not do if their illness/delusions were controlled. My mother is a paranoid schizophrenic, and when her disease is out of control will express many inappropriate wishes. For example, she has cancer, and on a number of occasions when her mental illness was at its worst, she has insisted that she wants to discontinue cancer treatment so she can die. We've worked through this in partnership with both her cancer care team and her health care team to determine if the request is driven by delusion or whether it is her genuine wish. What she has told me on a couple of occasions after she's been stabilized is that although she was asking to be allowed to die, on the inside, she was terrified that we would actually let her. She didn't *want* us to let her die, but her illness compelled her to say and do things which were not in her best interest. I hope this helps. The article is very short, but a psychiatrist's determination of incompetency is never made lightly.

As an exercise, consider how you would react to this story if the reason she gave for refusing surgery was that she was actually not human--she was an alien, and could easily heal herself of cancer using energy from a special crystal. Then would you privilege her "privacy" over the opinion of multiple doctors?
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Renee Babcock
User: renegade500
Date: 2011-03-09 19:43 (UTC)
Subject: (no subject)
The thing is, the only indication given for her "delusion" in the article is her religious beliefs. Again, there are a lot of unanswered questions here. If she is indeed under extreme delusions, it would seem to me she'd be under some kind of treatment for that. The context of the article doesn't seem to indicate that's the case.

Even mentally ill people (unless declared incompetent) have the right to decide their own treatments, regardless of whether the doctors agree or not.

For a court to declare a woman should get an extremely invasive surgery when I can't tell from the context of the article that there was really a reason to do so is overstepping. There's a big difference between her saying I'm an alien and my religious beliefs preclude me from doing something. Some may consider both to be different kinds of delusions, but it's still her right to do this.

I want the courts to be extremely conservative when it comes to declaring someone mentally incompetent (and that would extend to other facets of their lives, not just medical decisions). But it's interesting how there are more cases like this popping up regarding women and their rights to make medical decisions (that happen to involve their reproductive choices), but we don't see the courts getting involved with men's reproductive choices. If she were a man with testicular cancer, would the court order surgery? I somehow doubt it.
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cathshaffer
User: cathshaffer
Date: 2011-03-09 20:03 (UTC)
Subject: (no subject)
You are making a lot of assumptions outside of the facts presented in the article and also I think you are confused about "context." Do you see that you are predisposed to favor an appeal to religion, even though you have admitted you don't have all of the facts? Do you understand that she will die without the surgery?
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Renee Babcock
User: renegade500
Date: 2011-03-09 20:42 (UTC)
Subject: (no subject)
I can only go off the context of the article, and in that context (and trust me, I know a lot about context, one of the things I learned well in grad school), the doctor said the woman's religious delusions were preventing her from making fully informed decisions. In the same article it also said the woman was aware that if she did not get treatment she would die (although that seems uncertain at best, although certainly a pretty decent chance that she will). Based just on those pieces of information that sounds like she's making an informed decision. It's just a decision that some people don't seem to like.

In addition, the article mentions she's married - but my reading of the article doesn't seem to indicate that her husband has been granted any rights to make her medical decisions. Seems to me if she were declared incompetent, he should be given the rights to make those decisions. He's barely mentioned as an afterthought in the article. That also troubles me, especially since this is just the second time in a week where there's been a story of courts and doctors making medical decisions for women that just happen to be reproductive decisions.

BTW. you are also making an assumption about me and my "predispositions" without knowing anything about me. I'm not particularly predisposed to religion in any way, but I think using religious delusions as justification for a court to order sterilization of a woman is a very slippery slope. If anything I'm predisposed to letting adult women make up their own minds about their bodies, even if I think their reasoning is a little whackadoo. It's still their bodies.

I also think ordering a hysterectomy is a slippery slope. That's a pretty invasive, radical surgery that will have a dramatic effect on this woman's life, and it's not the only option for treating early stage cervical cancer. Will she die without the surgery - maybe - there seems a pretty high chance. But that doesn't mean you or I or a judge should force that surgery on her because of that.

People refuse potentially life-saving treatment all the time. When my dad was diagnosed with pancreatic cancer, he refused chemo. I wasn't happy with that decision, but you know what, it was his right to decide that, and I dealt with it. Because it wasn't my choice to make. (And just in case it isn't clear, I believe very much in an adult's right to bodily autonomy, including the right to decide when and how they die.)
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cathshaffer
User: cathshaffer
Date: 2011-03-09 20:54 (UTC)
Subject: (no subject)
You know, seriously, you are using the word context wrong. I don't know what you did in graduate school, but I'm having trouble getting past that. Here's a definition from dictionary.com

http://dictionary.reference.com/browse/context

I know you are not referring to definition 1, because that doesn't make sense. And I know you can't be referring to definition 2, because neither you nor I have access to anything outside the article itself. So I feel you must be trying for definition 3, "the fleshy fibrous body of the pileus in mushrooms."
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Renee Babcock
User: renegade500
Date: 2011-03-09 21:06 (UTC)
Subject: (no subject)
No, I'm not, and wow, really, you won't refute any of my other points (and have sidestepped them a couple times now) and instead get stuck on something unrelated. Okay, I don't see much point in going any further here.
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cathshaffer
User: cathshaffer
Date: 2011-03-09 21:54 (UTC)
Subject: (no subject)
I refuted your points in my original post. If you would like to be more informed about mental illness and issues of policy, please check out www.nami.org.

As for myself, at this moment I am weary of explaining to people why it is a bad idea to leave mentally ill people alone and let them make their own decisions. I understand you don't believe the woman in the article is mentally ill. You keep referencing the "context," so I can only assume the mushrooms told you that she is fine and it's really the bad government that wants to deprive her of her reproductive rights. I don't agree with you, but I do hope you'll follow the link above and take an interest in mental illness advocacy.
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mlerules: hello cthulhu
User: mlerules
Date: 2011-03-09 15:29 (UTC)
Subject: (no subject)
Keyword:hello cthulhu
Dang "503 Service Unavailable - No server is available to handle this request" error. On the upside, mebbe it means many folks're swarming to sign the petition (GdT&MoM)!

**************************

Qx o' Day: Definitely the latter!

**************************

And the butterfly? trail sounded so promising...mebbe it'll be open again soon. :-(

**************************

People really are entitled to go to hell in their own way, so long as they don't take others with them. Spot on, IMHO. Still, a b!tch of a call to make...

Edited at 2011-03-09 03:31 pm (UTC)
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dionysus1999
User: dionysus1999
Date: 2011-03-09 17:46 (UTC)
Subject: (no subject)
Demigoth, it's a bit less revealing.
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