The more things don't change

Back when the world was young and the Internet still held lots of promise, and I was still stupid enough to read Wired (this would have been about 1994 or so, for those of you keeping track of these things), I stumbled on a Backlash column that said, basically, the information superhighway (gag me with a fork) was a big fat joke:

All the headlines about the digital, interactive, 500-channel, multi-megamedia blow-your-socks-off future are pure hype. Yes, all the wild Wall Street, through-the-roof, Crazy Eddie, cornucopia, shout-it-out-loud promo jobs are pure greed. It’s all a joke.

It’s now official. I’m announcing the beginning of convergence backlash. There will be no convergence. There will be no 500-channel future. There will be no US$3 trillion mother of all industries. There will be no virtual sex. There will be no infobahn. None of it – at least not the way you’ve been reading about it.

Sure the technologies are real. Digital compression and digi-tal phone lines are real. Those 100-MIPS micros are real. Multimedia and high-speed networks are real. In fact, the technology is so real that it’s almost obvious. Unfortunately, the businesses to exploit these technologies are anything but obvious.

The item itself is more about the topological and technological realities of cable vs. POTS as a method of driving bandwidth into the home, and it was more or less accurate in 1994. What’s weird is that it’s still accurate today — Telus still isn’t in the business of providing video on demand, and Shaw isn’t really in the business of providing dial tone (notwithstanding recent forays into that particular biz-ness*). While both are manifestly in the business of providing ridiculously cheap loss-leading consumer-grade bandwidth, the convergence we all expected to happen hasn’t happened yet. And it’s a decade later! Moreover, there’s no sign it’s going to happen anytime soon; I think most people have figured that out. Every time I hear someone talk about VoD or streaming HDTV or whatever delivered over broadband, and about how the technology to make this work is “just around the corner,” I think to myself: It was just around the corner in 1994, in 1997, in 2001…

(We did up with the 200+ channel universe, but what no one had predicted was that most of those 200 channels would suck. Hard.)

Apparently, “turning the corner” means the same thing for fans of convergence as it does for fans of questionable foreign policy adventures. And you plan to have that insurgency under control when, precisely? Right around the time the OC-192 lands on my doorstep, and doesn’t cost more than $80/month. Got it. I’ll get right on holding my breath. And really, how reliable is your Internet connection? Mine’s pretty good, but I freely admit that while Shaw periodically goes down on me (on average, once or twice a month that I notice, for fairly long periods (like, more than 2 hours)), I’ve yet to pick up my phone and not get a dial tone**. Ever. I mean, in my entire life. I’m not saying it doesn’t happen, because I know it does, but really, when was the last time your landline phone didn’t work?

Nothing ever really changes. And it seems like we’re doomed to repeat the last decade over and over again. Remember the Communications Decency Act, and the other unconstitutional legislative piles of crud that were foisted onna Innernet by Congress and well-meaning politicians pandering to a paranoid and hysterical electorate? Guess what! It’s back:

The Utah governor is deciding whether to sign a bill that would require Internet providers to block Web sites deemed pornographic and that could also target e-mail providers and search engines.

Late Wednesday night, the Utah Senate approved controversial legislation that would create an official list of Web sites with publicly available material found to be “harmful to minors.” Internet providers in Utah must offer their customers a way to disable access to sites on the list or face felony charges.

No word on whether “unplug your cable” counts as an approved method of blocking sites deemed pornographic. There’s also no word on whether this is Yet Another Opening Battle in the Looming War on Obscenity, now prosecuted by those brilliant guys who brought you the war on terrah. Jesus, my head hurts.

How can we make 2005 more like 1994? We’ve already got a pundit class announcing the end of something as we know it (back then: broadcasting and telephones; today: journalism). We’ve got scary government regulators lurking provocatively in the shadows, like the Russian army, waiting to pounce and kick the shit out of everyone (back then: porn and privacy; today: porn, privacy, and political speech). We’ve got piles of people crowding onto the network at a seemingly exponential rate (which is confusing, because you’d think we’d eventually run out of morons), each of them convinced they’re doing something revolutionary and dramatic and life-changing. What else do we need to turn back the clock and really re-live Internet hype once more? Oh! Oh! I know! Let’s fight the crypto wars all over again! It’ll be so retro, and cool, and we can all feel like a persecuted minority once more, and shout “cyber rights NOW!” like it means something, and.. oh, never mind. I don’t have the energy***.

And here I was, naive enough to think that we’d reached the point where the network might just be a tool, no more, no less. Bah.

* I freely admit to being intrigued by this service and would like to know more about it, assuming they ever get it out of Calgary. Unlimited long distance and my phone system for $55/month on top of my existing cable bills? w00t, baby, w00t.

** Assuming, of course, that I’ve paid my bill.

*** My tentative list of names for the blog that will inevitably follow Under a Blackened Sky: “Wanker With a Weblog,” “Digital Curmudgeon,” and “Get the Fuck Offa My Network, You Arriviste Punks.”

I can't believe it's not sucktastic!

The latest news from Arizona in the neonatal baseball season is John Hickey’s profile piece on Adrian Beltre, the new starting third baseman for Your 2005 Seattle Mariners. I look at this article, I look at his career and 2004 statistics, and I look at his 2005 PECOTA projection and comparables (.279/.337/.486 weighted mean, and this is probably hilariously conservative), and I think to myself: Holy shit, I can’t believe we actually got this guy playing for our team.

Adrian freakin’ Beltre. It still brings a smile to my face, two and a half months later. I can’t believe this actually happened. Whoo.

Mail problems

I can’t get at my e-mail at the moment — my mailhost has decided to stick its fingers into port 22 and sing “la la la I can’t hear you!” as loudly as it can. (And POP’s been broken since before Christmas — I can LIST just fine, but RETR sends the mail headers and then hangs up. Any ideas?) As a result, any urgent e-mail you’re trying to send to me… won’t actually make it anywhere near me until this gets resolved.

Highly frustrating, but what can you do?

But extra special congratulations go out to my font wizard pal for his big win at work, and mad props go out to other people who know who they are for reasons they already understand.

The courage to pull away

I see (mostly by way of this) that the Terri Schiavo case is back in the news, thanks to the trial being finished, and the judge having rendered a decision, with implementation of the decision to begin soon-ish. Everything I want to say about Schiavo I’ve already said before, but there’s at least two things that bear repeating.

First of all, the comment in the Shotgun about death by dehydration is curious. Some quick Googling reveals that the quote by Dr. William Burke comes from a book by Wesley J. Smith entitled Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder, and you don’t have to spend any sort of quality time with Google or Amazon to figure out what kind of agenda that book is trying to push. (Indeed, most of the examples of Smith’s writing has struck me as deeply, um, hysterical, and his comments about the “death culture” within medicine leave me scratching my head: How come nobody told me about this?) Dr. Burke is a professor of neurology at Saint Louis University School of Medicine where he spends at least a chunk of his time dealing with Alzheimer’s patients, which means he’s probably got at least some familiarity with palliative and end-of-life issues, so I have to accord his perspective at least some respect.

Unfortunately, his position — that dehydration is a “bad death” — doesn’t seem to be supported by the evidence. Ganzini et al, writing in the New England Journal of Medicine, found that it ain’t necessarily so: “Nurses reported that patients chose to stop eating and drinking because they were ready to die, saw continued existence as pointless, and considered their quality of life poor. The survey showed that 85 percent of patients died within 15 days after stopping food and fluids. On a scale from 0 (a very bad death) to 9 (a very good death), the median score for the quality of these deaths, as rated by the nurses, was 8.” I know a lot of nurses, and I don’t think any of them would rate a death that involved seizures, extensive bleeding from mucosal membranes, and repeated vomiting episodes as a “good death.” It seems odd that the only article I’ve been able to find on the topic very nearly directly refutes Dr. Burke’s position (which has bounced around the echo chamber, almost without citation, since this whole mess resurfaced).

There’s an interesting interview with Dr. Ganzini over at Medscape (I’ve linked to Google’s cache, so you don’t have to register) where she talks about some of the meta-issues involved in her 2003 study. One point she made caught my eye:

[Voluntary dehydration] has been going on long before our study, but it hasn’t really been discussed. I hope this study will put it out on the table to increase discussions about it. The healthcare profession has always allowed terminally ill patients to refuse food or fluids for comfort reasons, such as anorexia or nausea, but now we need to talk about it in those patients who do it to hasten death. It needs to bring about a broader discussion of how we can improve palliative care and meet unmet needs.

Yeah. What she said.

Secondly.. well, I hate quoting myself, and think it’s the height of arrogance, but I already said this once and doubt I could ever put it again so well..

Here’s something to think about: If you believe that a competent adult has the right to decide to die, and to refuse particular forms of medical care to further his goal of dying,

.. meaning that if Terri Schiavo could have made this decision for herself (never mind if she would have, let’s work with the decisions she could have made)…

is it appropriate to prevent a decision-maker for that individual from making the same choice for him in the event he is born incompetent or becomes incompetent at a later point in life? Is there a difference? The activists would have you believe that of course there’s a difference, that the difference is critical, but is it really? The argument is framed in the context of promoting equal protection and equal rights, but it’s really just a special pleading: Equal protection and equal rights would necessarily require a proxy be capable of making those choices for an incompetent individual, because otherwise said individual would not be equal. Options that would be open to them were they competent would be closed solely by virtue of their incompetency, and that’s (say it with me) discrimination.

Even if the [activists] are right, and the criteria we use for basing decisions about life and death for incompetent individuals are biased in favor of the able (they frequently use the awful word “ableist”), so what? We’re in this mess because congenitally incompetent individuals do not possess value systems, and so we must find some system into which we can place these individuals; we look, under these circumstances, to society at large. And we ask the questions that we would ask of ourselves were we in the same place; we use “reasonable person” standards of judgment. For those individuals who become incompetent later in life, we use the values of the society to which the individual was raised and lived and is (arguably) still a part of. If you don’t like this, you need to come up with a system that allows for a different values system to be imposed upon the incompetent that do not place them at a disadvantage compared to the rest of us — unless you’re willing to be inconsistent and argue for accomodation and no special treatment when it suits you, and very special treatment when it doesn’t. …

In the absence of clear, compelling evidence to the contrary, one can only attribute to an incompetent person those values that would be possessed by a reasonable member of the society in which that person lives. This does not mean opinion polls. This does not mean “what the church thinks.” This does not mean 95% of what people think it does when they talk about societal values. It also doesn’t mean “what does society think a proxy decision maker should be able to do.” It does mean “what does society think an individual person should be able to do for themselves” — a very different question, and one that has been repeatedly missed.

This point gets missed, repeatedly. The point is free to be argued or rejected, of course, but it is truly aggravating that it isn’t even considered most of the time.

I think a lot of the heat and light over this issue probably has something to do with the reflex revulsion we have to it. But that’s not a good foundation for public policy, and not a good foundation for medical decision-making. We don’t like thinking about end-of-life issues, and although most of us know we’re going to die, I suspect most of us don’t actually believe it, and that drives a lot of our popular thinking about death and dying. (Personally, I’m not afraid of death. I am, however, very afraid of dying. It’s not the same thing.) We’re not doing ourselves any favors by talking about these issues in hyperbolic terms, throwing the “murder” label around, and arguing in favor of a wholly imaginary conspiracy against incompetent individuals and a culture of death.

There are those who think all deliberate death — whether by an individual’s own hand, or by someone else’s, whatever the circumstances — is a sin, immoral, and an unconscionable act. I can accept that. But I don’t believe that’s true by any objective standard, or that it’s useful as a starting point for discussions about death. And I also believe that there is such a thing as a good death, and that it is not only appropriate by required for physicians, nurses, and other health care providers to say, “That’s enough,” and let nature take its course. These choices were easy when people died at age 40 from disease we laugh at today, and were simpler when we didn’t have ICUs and ventilators and invasive feeding tubes, but people don’t die at age 40, and we do have intensivists who can keep shockingly sick people alive far longer than they ever would have lived at any point in the past. Does this constitute progress? I don’t know — it depends on the person and it depends on the disease. And it also depends on the prognosis, and the expected clinical course.

As I’ve said before, I have no real opinion one way or the other about what should happen to Terri Schiavo. It sounds a lot like I’m arguing in favor of discontinuing her feeding and perhaps I am, but that’s not the position I’ve carved out in my head. The positions I’ve taken in all my writing on the subject are generally in opposition to those held by people who want her kept alive, mostly because they’re using arguments that I find truly repugnant (or stupid, or just plain wrong) to justify their own positions. I’m sure that, if I spent enough time, I could construct equally valid criticisms for the other side, but as they say, this is my Web page, and the other side’s arguments don’t piss me off nearly as much. Even that’s saying something — the fact that this case is seen by many as having sides is highly irritating. It’s not about what side you’re on, or what you believe is morally right or wrong, or what you think the role of the state is, or whether you’re a life-loving conservative or a death-worshipping liberal.

It’s about what’s right for one specific person, and who gets to decide what’s right for that person.

And in their haste to score points in the ever-escalating rhetorical war against the demons of The Other Side, it seems as though politically-oriented commentators forget that a lot.