November 13, 2009

Religious Exemptions--Skeel

At a law and religion conference at Seton Hall’s law school yesterday, Rob Vischer, a law professor at St. Thomas, gave a fascinating talk that touched on the debate over religious exemptions—the question whether religiously oriented individuals and businesses should be protected from discrimination claims. This issue arose when a photo shop was sued for refusing to provide photography services at a gay wedding, and in cases challenging pharmacists’ refusal to dispense birth control or abortion pills. Vischer argues that the cases should focus less on the parties’ competing claims of conscience than on whether the declinations genuinely interfere with the plaintiffs’ access to these services (in many of these cases, they don’t). Among other things, such a shift might better protect the ability of businesses and other associations to govern themselves as they see fit. 

An obvious question with this approach is whether it would also have justified the refusal to serve blacks that characterized the Jim Crow era. Vischer acknowledged this concern, but argued that Jim Crow race practices shouldn’t be our template for thinking about the current issues. The harms in that era were much more systematic and severe than the harms claimed in the recent cases.
 
I don’t often think in terms of the consequences of social sin. But it seems to me that the way in which our country’s experience with slavery has complicated the debates on so many other issues—and has invited absolutist claims about what equality requires—is part of God’s punishment on our country for the sin of slavery.   Had it not been for slavery and the ongoing legacy of racial discrimination, the national discussion of these other issues surely would have looked quite different.
 

October 29, 2009

Bailouts and Preemptive Strikes--Skeel

One of many interesting questions I was asked while presenting a paper called “Bankruptcy or Bailouts?” at Professor Ted Janger’s bankruptcy seminar at Brooklyn Law School yesterday was whether there’s a connection between the ethos that led to the Bush adminstration’s preemptive strike policy and the Obama administration’s enthusiasm for bailouts. The question echoed a thought I’ve had often in the last few months. The Bush administration was criticized (fairly, in my view) for its secrecy and its “my way or the highway” attitude on foreign policy issues. Barack Obama campaigned against this ethos, and his administration has been far more transparent on foreign policy. Yet when it comes to economic issues, the Obama administration’s key financial regulators have been as high-handed and opaque as the Bush administration was on foreign policy.

 A preemptive strike is a little like a military version of a bailout.  And the ethos that produced that policy seems to have migrated, in the Obama administration, from military issues to economic ones.

October 21, 2009

Health News, and the Cost of Cancer Treatment--Stuntz

I haven’t posted for far too long; sorry about that. I’ve been hunkered down, trying to manage chemo—which is harder this time around than it was last year—and also trying to make some progress on a book I’m writing.

So, a quick update: When I last posted, the docs had found a cluster of tumors in my abdomen, plus one tumor on my liver. I started chemo immediately. Three weeks ago, I received news of my latest set of films: the tumors haven’t shrunk, but they haven’t grown either. That’s good news—though, as always in Cancer World, news is double-edged: it means I’ll be on chemo for at least several months longer. When (I’m past the stage where it’s appropriate to say “if”) the tumors resume growing, the docs will try a modified chemo regimen. Whenever that fails, we will look either at clinical trials or palliative care.
 
Those films also turned up a blood clot in one of my lungs, which the doctors found worrisome. I’m giving myself daily injections of a blood thinner, a small piece of unpleasantness on top of cancer treatment.
 
As Americans debate reform of the health care system, I increasingly wonder at the cost of my own medical care. At this point, chemo can extend my life only modestly; there is only a slight chance I will live more than eighteen months. Less is more likely.  The tradeoff seems worth it to me, for now: I want to be around to pay more of our youngest child’s college tuition, so that Ruth need not pay those bills out of life insurance money she may need for herself. I’d also like to finish my book, and spend more time with family and friends. But while those desires are perfectly legitimate, it is also perfectly legitimate for others—my colleagues whose insurance premiums pay for my medical care or the taxpayers who would do so under a government-funded insurance plan—to conclude that my preferences do not merit the huge costs required to (possibly) extend my life a few months. How best to negotiate that gap between my preferences and the public interest, not just for me but for the many patients in circumstances like mine, is a mystery to me. But I doubt we will ever get control of health care costs if preferences like mine continue to govern in cases like mine. Which makes me wonder whether I have a moral obligation to cease chemo sometime in the near future, and let my cancer take its natural course. Not a pleasant thought, but not a foolish one either. At least, so it seems to me.
 

October 6, 2009

Stuntz on Suffering

Bill had an article called "Three Gifts for Hard Times" in the August issue of Christianity Today, which I suspect will be of particular interest to those who have followed his posts on his cancer treatment.  I just noticed that the article is now available electronically here

DealBook Dialogue on the Financial Crisis--Skeel

The NY Times DealBook blog is hosting a dialogue on the financial crisis, with a variety of folks (I'm the least of them, by any yardstick) weighing in.  Several of the initial columns have been quite interesting; it's continuing all week here.

October 4, 2009

The Ardi Fossils--Skeel

I happened to be reading the transcript of the 1925 Scopes (“Monkey”) trial the other evening, then woke up to front page pictures of Ardi, who was described “a 4.4 million-year-old human forbear.” Scopes and Ardi prompted a swirl of competing thoughts and emotions, but two thoughts stood out.

The first is that a trial is the worst possible place to debate these issues. In a trial, the parties try to concede as little as possible, rather than acknowledging the strengths as well as weaknesses of the opposing position. Attacks on evolution tend to attack particular elements of evolutionary theory—pointing out limitations in the fossil record, for instance—and treat this as disproof of the theory as a whole. Evolutionists tend to point to difficult Biblical texts or bloodshed in the name of religion—and treat this as conclusive evidence that Christianity is not true. Linking a handful of problematic details and inviting a jury to draw a sweeping conclusion is a classic rhetorical strategy in trials.
 
Second is the issue of humility. In the Scopes trial, Darrow repeatedly referred to religious critics of evolution as “bigots and ignoramuses,” and was cheered on by the East Coast press. He wasn’t treated much better by William Jennings Bryan and the defenders of the anti-evolution law. This absence of humility has characterized the subsequent debate as well, and is reinforced by its judicial, point-counterpoint quality. (Think of a few of the best known books: Darwin on Trial; God is Not Great). Greater humility might mean more acknowledgment of the limitations of evolutionary theory by evolutionists, and more willingness by Christian critics to marvel at the mysteries reflected in the decoding of genome or the discovery of fossils like Ardi.
 
The stories about Ardi noted that her discoverer, Tim White, waited many years before finally going public, painstakingly piecing together a large number of fossils even as fellow scientists pushed him to announce his discoveries. I don’t know anything about Dr. White or his reasons, but I like to think he wasn’t interested in firing salvos into the science vs. religion debate as soon as he could. Instead, he wanted to be as careful as possible, and to pursue the best understanding of the significance of what he and his team had found, without paying attention to the battles playing out on the best seller lists.
 
 

September 14, 2009

Deer--Skeel

As the days shorten and fall activities begin, one of the summer rituals I will miss most is sitting on our back porch at the end of the day. At around 7pm most days, white tailed deer—usually two or three—strut across the yard to our neighbor’s apple tree. If they notice us, they freeze for a minute or so, ears flattened, then resume their foraging. Sometimes they chase each other around the neighbor’s very large yard. Once or twice, we’ve seen them stand on their back legs for a few seconds, trying to reach higher apples. It’s amazing to think such large, beautiful animals live in the small pockets of woods of our suburban township.

The herd has steadily increased in the twelve years we’ve lived in this northern suburb of Philadelphia. Gardeners trade tips on how to keep them out—a fence still seems to be the only foolproof strategy. I think the township should allow periodic hunting to reduce the number of deer, but not in my backyard. I know my wife agrees, at least with the backyard part. A decade ago, when our children were small, she looked out and saw two hunters traipsing across our lawn with crossbows. Asked what they were doing, they said the owner of a nearby wooded property had given them permission to hunt, and they were tracking a deer they thought they’d hit. My wife made it very clear they wouldn’t be doing any tracking near us. They seem to have gotten the message. We haven’t seen any hunters since.

September 8, 2009

Life Issues and Healthcare Reform--Skeel

 A key issue with both life issues that have flared up in the healthcare debate—“death panels” and funding for abortion—is coercion. If healthcare reform requires doctors to consult with their elderly or other patients about end of life healthcare options, and facilitates funding for abortion, will patients be pressured to forego costly life preserving interventions or to have abortions?

I think the danger is greater with abortion. Although pro choice advocates often scorn the claim that doctors pressure women to abort, I’m firmly convinced they do. I’ve seen it happen, even in my sheltered little world. It’s easy to see why. If tests show a high risk of problems, a doctor can’t help but fear she’ll be blamed, and possibly face a big malpractice suit. If the doctor is pro-choice, there’s a powerful incentive to push for abortion. Some, perhaps many, do. Any healthcare bill that increases funding for abortion, whether directly or indirectly, will make it easier for doctors to prod more people to have abortions.
 
With elderly patients, on the other hand, doctors do not have the same perverse incentives. Regardless of which treatment a doctor counsels, she is not likely to be sued by the patient’s family if the patient dies. So long as the doctor with whom the patient consults does not have a financial incentive to steer patients away from life preserving interventions, the risk of coercion is relatively low. 
 
The death panels have made for dramatic talking points, but I think the more frightening issue is the risk that the coming reforms will mean more money and more pressure for abortion.

August 26, 2009

Kennedy's Passing--Skeel

Like nearly everyone who does not inhabit the left, I’ve always had deeply mixed feelings about Ted Kennedy—admiration for his dedication and accomplishments mixed with distaste for his partisan excesses and the seamy side of his personal history.

Soon the historians will go to work, putting his legacy into perspective. I believe that his decision to throw his support to Barack Obama in the Democratic primaries last year will be viewed as one of the shining moments of a remarkable political career. The easy decision would have been to support the establishment candidate. But he put the Kennedy name behind the candidate who could open a new page in American history, much as J.F.K did.

In political terms,Ted Kennedy surely will be remembered as one of our greatest senators, much as the nineteenth century triumvirate of John Calhoun, Henry Clay, and Daniel Webster are.

Bernanke--Skeel

In announcing Ben Bernanke’s nomination to another term as Federal Reserve chair, President Obama said he "approached a financial system on the verge of collapse with calm and wisdom." This seems a fair characterization of Bernanke’s personal demeanor, but an odd description of the Fed’s response to the financial crisis. Several of the Fed’s rate cuts and interventions in 2007 and 2008 were more panicky than calm.

The question now is how Bernanke and the Fed will handle the winding down of the Fed’s money printing machine in the coming years. Here, the danger is that Bernanke will wait too long to tighten credit, for fear of triggering another recession. As a student of the Depression, which was exacerbated by tight money, Bernanke seems much more comfortable flooding the economy with money than cutting back.
 
In a bank, the person who makes a loan is never the same person as the one who negotiates with the borrower if things work out badly.  The skills needed for the two jobs are quite different, and banks fear that the loan officer will not be able to make an objective decision when to cut a borrower off. The same may hold true for the Fed. Although Bernanke’s performance surely warrants a second term, he may need to be pushed to step down in favor of a new, unsentimental chair—Larry Summers?—when the time comes to seriously tighten credit. The question is whether anyone will have the gumption to do the pushing.