Friday, December 31, 2010

Tony Proudfoot

Perhaps courage is in short supply in our times. But the charge cannot be levelled against Tony Proudfoot

Proudfoot died yesterday from ALS, or Lou Gehrig's disease. Diagnosed in 2007, Proudfoot continued with his life at full pace. Most notably, he continued working as a radio broadcaster of Alouettes' football games, despite his impeded speech. And his foundation raised more than a half-million dollars for ALS research. 

I should also like to note that in the fall of 2006, when a gunman entered Dawson College and began shooting, Proudfoot left his office in that college (where he'd taught for many years) and administered first aid to a wounded student, despite the obvious and mortal danger. 

What courage, and what character. 

Monday, December 13, 2010

On altruism and organ donation

This weekend, the Toronto Star ran a remarkable story about a man who gave an anonymous liver transplant. You can read it here, along with an accompanying video.

By some metrics, this is an act of near pure altruism. This man gives something of himself to save someone else, without any material benefit. Ah, but you say, he receives the benefit of the admiration of his neighbours, his colleagues, and most certainly his wife, with whom he made the decision to give. But once reading the story, one gets the sense that he made the decision to give long before this admiration was due to him. Indeed, it was only after deciding to give and booking in for the procedure that he explained it to his colleagues and friends.

Perhaps he anticipated their praise and admiration, and this compelled him to give. But, there is an equally plausible story in which he felt some urge or impulse to do this act, quite apart from the expected praise. He felt a warm glow. This glow is merely prolonged by the admiration of others. There is, perhaps, a more purely altruistic mechanism at work here than a cynical account would suggest.

That's up for readers to decide, I guess. Either way, it's inspiring stuff.

Friday, December 10, 2010

On homelessness and the ethics of randomized controlled

The NYT has a very interesting article up on a randomized controlled trial for a homeless program in NY.

A social agency in New York runs a program which helps poor people with housing. The objective of the program is to prevent people from becoming homeless. It competes and works with several other programs to achieve this objective. However, they face a small problem: they have no idea if their program works. So, the organization has decided to randomly assign some people to enter their program, while denying others the right. 

You've read that correctly: they randomly chose some people by some lot or another to receive assistance, while others are denied it by virtue of the same draw. Dear reader, your initial reaction is probably that this is terribly cruel. This is certainly the reaction of many in NYC who are now opposing this trial. I'd like to argue that this is the most ethical course of action, in terms of both procedure or means, and ends. 

Two arguments recommend my position. First, while we should be concerned that social programs are just in their procedure -- think about the difference between feeding the poor respectfully and throwing them food from the back of a truck -- we should be most concerned that they are effective in their outcomes. Randomized controlled trials tell us more than any other method ever can whether a program has a negative or positive causal effect. This is no small matter. We waste billions of dollars every year on social programs that are meant to make peoples' lives better with virtually no systematic evidence that these programs work. If you believe that policy makers have an obligation to help the citizens who rely on them, then good intentions are not enough. We need to do our best to figure out what programs actually work and which do not. RCTs are the best way to do this. 

Second, this program suffers from scarcity, such that not everyone who applies can be accepted, despite their suitability for the program. So, we need some mechanism to decide in a fair manner who is admitted into the program and who is not. In the absence of randomization -- in which everyone has an equal chance -- some other criteria must be used. Now, a policy maker could select on need or suitability, or some other metric, but selecting on this eliminates the ability to figure out whether a program is effective, because you can't be sure that any differences in outcomes between those in the program and those out are a function of the program or the differences on which entrance into the program was granted. Alternately, a policy maker could grant access to someone they simply like more than others. This assuredly happens more often than we'd like to admit. I am sure there are other criteria, but the point remains that these other methods either limit our ability to measure outcomes, or they are arbitrary. In the worst case, they are both of these things. Contrast this with random assignment, in which everyone has equal chances of service. This is many scores more ethically defensible than some arbitrary selection mechanism. 

Experiments may seem unfair at first glance. After all, we don't like to think of humans as subjects in an experiment. But better subjects than participants in a series of arbitrarily administered and monitored programs bound for continued failure. That's more cruel than a coin flip. 

Tuesday, December 07, 2010

One more thought on BC

Given that the leaders of both major parties in BC have been pushed out by factions in their caucus, it appears that elected members are more powerful there than elsewhere. If this is true, how much of it is because of fixed election dates? In the absence of these set elections, one can imagine party leaders holding more sway over risk averse caucus members who fear a snap election under an interim or a new leader. But now, with the election date set, members know how much time they have to elect a new leader if they push out the current head. This is speculation at best, but the hypothesis has some face validity, I think.

Monday, December 06, 2010

A win for caucus authority?

Carole James has been made to resign as leader of the New Democratic Party of British Columbia. (The Globe has a quick story here).

This is the short story. James has faced serious dissent in her caucus, such that 13 members (out of a caucus of 35), have publicly signalled their wish for her to go. However, two weeks ago she won the support of her party's provincial council, which is some group of its elected and appointed riding executives with some union members thrown in for good measure, I am sure. I suspect Royce Koop knows for certain. Anyways, armed with this endorsement of party members, James' leadership looked secured. However, she met with just one of the 13 dissenters since then. The pressure on her increased when Jenny Kwan, a member of her caucus, released a long statement asking her to resign.

This is not a perfect battle between the authority of some unelected party members and elected members of the legislature, if only because the dissenters among the latter don't represent a majority in their caucus. But, it's close enough for the purposes of noting that a caucus has just turfed its leader for for the second time in BC politics in less than a year. This is a victory for those who think that elected politicians should have more say over who leads them than party members. I can preach it round or preach it straight, but for now it's enough to note that this is good evidence that the supremacy of parliamentary leaders in Canadian politics is not absolute. This is a very good thing.