Brainwashed into pleading guilty: rights denied to one are denied to all.

This has been all over the news, but it's enough of an outrage (and gross violation of human rights) that it seemed the perfect opening salvo for this born-again cynic.

Omar Khadr was arrested in 2002 as a fighter for al-Qaeda after killing an American soldier with a hand grenade at the age of 15.  He has spent the majority of the last eight years imprisoned at Guantanamo bay--over a third of his life--and, having plead guilty, is facing at least another eight years behind bars.

As a fighter for a "terrorist" organization, the United States government does not consider Khadr to be a prisoner of war.  According to international law, prisoners of war are entitled to combatant immunity and may not be prosecuted by their captors for legitimate acts of war (e.g. killing an enemy soldier in combat).  It is only Khadr's extra-legal status that allows the United States government to prosecute him.

The question of Khadr's status hinges on whether captured al-Qaeda fighters are to be considered (in the eyes of international law) "lawful" or "unlawful" combatants.  On the one hand, terrorist organizations, like al-Qaeda, are large multi-national, non-sovereign, criminal (therefore, unlawful) organizations; on the other hand, the organizational structure and tactics of certain pockets within these organizations mirrors that of "lawful" guerrilla movements--entitling captured fighters to POW status per article 4 of the third Geneva Convention.

Obviously, the senior leadership of al-Qaeda is responsible for atrocities that lie far outside the legal definition of "acts of war".  Indeed, in addition to international terrorism, there is evidence that al-Qaeda is engaged in international drug smuggling, money laundering, and weapons dealing.  However, the persons involved in these activities are in violation of international law and, as such, may legally be prosecuted (for these activities) upon capture regardless of POW status.

Additionally, it is highly unlikely that the average al-Qaeda fighter on the ground in Afghanistan is even aware of, or (if they are aware) even peripherally involved in, the global crime syndicate they claim to represent.  In the most reductive sense, these fighters represent a militant organization that, at least in Afghanistan, finds itself in direct conflict with the military of a sovereign nation--a military opposing them under the auspices of war.  It is, therefore, not unreasonable to consider fighters captured in such conflict prisoners of war entitled to all the rights guaranteed by that status.

As for Omar Khadr, it is unlikely that a fifteen year old boy would be fully cognizant of the potential ramifications of joining al-Qaeda.  Furthermore,  given his age and stated family history, it is likely that he was coerced into joining al-Qaeda and was not affiliated with that organization entirely of his own free will.  When he was captured, he had been wounded in a gunfight between US forces and other al-Qaeda militants; when Khadr threw the grenade that killed a US soldier he was under fire--thus, killing the soldier was not an act of cold-blooded murder, but an act of self-defense against an armed attacker; an armed attacker acting as a combatant in the execution of a declared war.

Considering the length of Khadr's captivity, and the conditions of his captivity, his guilty plea is nothing more than a surrender.  He is a victim of circumstance who poses no real threat to the people of the United States yet the people of the United States have ruined his life.  Regardless of his statements in court, he was branded with the identity of a terrorist during his most impressionable years--any ideological statements he makes now are not the product of al-Qaeda, but the product of the ordeal he has been through in the past eight years.  This man's life now amounts to nothing more than that of a political pawn who's rights were disregarded in the name of "freedom".

The Cynic Returns!

After a three month hiatus from blogging (necessitated by school, MCAT, med school apps, etc.) I have decided to return to the world of blogging!

Having received constructive feedback about my previous entries (thanks to all of you who, at my incessant urging, read them), I have decided to institute a few changes in the way that this blog is kept:

• Rather than long-winded, technically worded, entries, the entries posted will be shorter, and more numerous.
• There will be fewer entries babbling about science, and more about politics and recent events.
• As always, so long as they do not contain obscenities, comments will never me moderated.

That said, let's get cynical!

Pressure Washington to Sign the Global Cluster Bomb Convention!

First developed by the Germans for use in World War 2 as an airborne anti-infantry weapon, cluster bombs of various designs have become a standard part of the modern military arsenal.

The basic idea behind cluster bomb design is simple. Rather than comprising a single large explosive intended to be dropped on a specific target, they are designed to disperse several smaller explosives over a larger, less concentrated, area.

Cluster-bombing strategies have proved useful not only against infantry, but also for knocking out an enemy's essential infrastructure (e.g. pockmarking runways with hundreds of small craters to render them unusable), and laying minefields.

The danger posed to civilian bystanders by any weapon designed to distribute a non-specific swathe of destruction over a large area is obvious. Indeed, since their introduction, the use of cluster bombs has accounted for a disproportionately large number of civilian fatalities when compared to other, more "targeted", munitions. Even after a particular war has ended, unexploded "bomblets" and aerially dispersed minefields have been known to claim scores of innocent lives.

Yesterday, an historic international treaty banning the use of cluster bombs, the "Convention on Cluster Munitions", officially went into effect. As of the time of this writing, 108 countries have signed the convention of which 38 have ratified it. While, with the exception of the UK, none of the countries in which it has been ratified are what would be considered "major" global military powers, its signatories collectively represent about half of the world's population.

Unfortunately, out of the 14 countries known to have used cluster bombs in recent history, only 8 have signed the convention and, of these, only 2 have ratified it. The six countries that have both used cluster bombs and abstained from signing the treaty are Eritrea, Ethiopia, Georgia, Israel, Russia, and the United States. Among all of the "free" and "democratic" nations of the first world, only Israel and the United States have not signed the convention.

The failure of both Israel and the United States to sign this convention is both a humanitarian and foreign relations travesty. While, given it's sometimes tenuous position on the world political stage, Israel's failure to sign is perhaps understandable if not forgivable, the failure of the United States to sign the convention is virtually an admission of guilt to the general disregard for civilian lives alleged by so many of the United State's enemies.

The era of American hegemony fueled with blood must come to an end if the United States is to maintain its position of global political and economic influence. From the Korean war to Iraq, hundreds of thousands of civilians, and hundreds of thousands of American citizens, have died to protect American political interests abroad. This state of endless war has only fanned the flames of dissent sown throughout the world by the United State's enemies. What could possibly be a better way to douse those flames than demonstrating to the world a newfound commitment to preventing unnecessary fatality?

In order for the United States to ratify a treaty, it must be both approved by a super-majority (2/3) of the senate and signed by the president. Accordingly, it now falls to the people to put pressure on their state's federal senators and on President Obama to add the United States to the list of countries agreeing to refrain from using such weapons.

Thus far, there is little publicized public effort to do this. In the next day or so, I will create a petition on change.org and draft letters to the president and my state's Senators and post them on here for sufficiently motivated readers to copy and send for themselves.

This Made Me Laugh...

Age of Autism is sponsoring a contest to "win" lunch with "Doctor" Andrew Wakefield...

While I have no money to bid in an auction, I think that a coalition of legitimate scientists should band together and try to win it--if only to spend the awkward lunch hour grilling him on medical ethics and sound science practice.

Vaccination: A Love Story

(Dear reader, I apologize in advance for the rather cliche topic of this post...I'm just fed up with all of my comments getting moderated off of age of autism.)

Perhaps one of the most pernicious aspects of the culture war is the anti-vaccination movement. Driven by charismatic celebrities such as Bill Maher and Jenny McCarthy, an army of soccer moms, and a handful of ethically dubious fringe scientists, the "anti-vaxers" represent one of the greatest extant immediate threats to general public health in the developed world. Since its modern beginnings in the early 1990's to the present day, the movement has accrued a cult-following of otherwise well-meaning people that has done nothing but hinder the progress of science and cause unnecessary human fatality. Contributing to the movement is both a general lack of understanding of the science behind vaccines among the general public and clinicians, and a not-wholly-irrational public distrust of the pharmaceutical industry. Addressing this issue will require effective and persuasive communication of vaccine science to both the general public and practicing clinicians.

As a safe and effective preventative counter-measure to infectious disease, vaccination is far from a modern concept. Primitive vaccination protocols can be found in ancient aryuvedic texts from India, and the procedure was widely practiced in the Muslim world until it was introduced to western medicine by Lady Mary Montague and (more famously) Edward Jenner in the 18th century. While the technology of vaccine production and delivery has changed over time, the basic concept that a specific immune response can be "primed" in a person to render immunity to a pathogen prior to exposure remains. In order to properly explain the mechanism at play here, it is first necessary to briefly explain how immunity works.

In the most reductive sense, the human immune system differentiates between things that are supposed to be in the body (e.g. one's own serum proteins and cells) and things that are not (e.g. viral coat proteins, bacteria, and even cancer). To accomplish this task, and eliminate those items that fall into the latter category, human immunity functions through two broad mechanisms. Innate immunity is just that, innate, upon contact with any foreign biotic material, it functions to quickly and efficiently eliminate it. Sometimes, however, this non-specific first line of defense is breached and, in the case of infectious disease, the body needs to break out the heavy artillery.

The components of adaptive immunity represent the body's version of guided missiles and surgical strike commandos. Upon exposure to an antigen, macrophages (the "storm troopers" of innate immunity) present the antigen to adaptive immune cells and trigger proliferation of cells specific to that antigen. These adaptive immune cells fall into two categories, B-cells and T-cells. B-cells produce antibodies, proteins capable of recognizing a specific antigen and facilitating its destruction; once the body starts producing antibodies against a specific antigen, it will continue to do so--granting immunity--throughout life. T-cells are a bit more diverse, and fall into several subcategories, but their general role is to recognize and kill infected and pathogenic cells. Following exposure to a specific antigen, "memory T-cells" specific to that antigen persist throughout life and can proliferate quickly to mount a specific response in the event of re-exposure. Vaccines induce adaptive immunity to a particular pathogen so that, upon exposure, the body already has a specific response.

Modern vaccines fall into five broad categories, attenuated, killed, subunit, toxoid, and conjugate.

Killed and attenuated vaccines are technically the simplest to produce and the earliest vaccines generally all fall under these two categories. These vaccines work by introducing killed, noninfectious, or weakly infectious versions of the infectious pathogen into the body thereby simulating infection and inducing an adaptive immune response. While certain attenuated vaccines may cause infection in immunocompromised individuals, and many of these vaccines must be refrigerated to be kept "fresh", they have become one of the safest and most reliable counter-measures to infectious disease in use today.

Subunit, toxoid, and conjugate vaccines work by introducing biomolecules specific to a given pathogen rather than the pathogen itself. Vaccines in this category can be used to develop an adaptive immune response against bacterial lipopolysaccharides and even small organic molecules. Because, with the exception of some toxoid vaccines, recombinant DNA technology is required to produce them, vaccines in these three categories did not enter wide-spread clinical use until the latter half of the 20th century. Because they contain no potentially infectious particles, these vaccines pose no risk of causing infection. Additionally, some of them can even be stored "dry", greatly increasing their shelf-life. These vaccines are highly safe, with the clinical trials for a few of them producing no statistically significant life-threatening effects.

Re-enter the anti-vaxers. The most common ailment blamed on vaccinations is autism. Much of the momentum for this belief was provided by a now-retracted-and-thoroughly-disproven paper published in the Lancet in 1998. No peer-reviewed publications have ever presented even a hypothetical pathogenic mechanism for such a causal linkage; in fact, much of the anti-vaccination fervor has focused on pseudoscientific vagueries such as "toxic load" and "vaccine load."

"Toxic load" as defined by the anti-vaxers refers to the idea that trace chemicals or preservatives present in the vaccine induce autism. Several studies have thoroughly discounted this concept. The only potentially scientifically valid tenet underlying this idea is several public health studies that have shown a (barely) statistically significant correlation between environmental mercury content (defined variously as soil concentration, drinking water concentration and atmospheric concentration) and local prevalence of autism. Unfortunately, a biologically insignificant amount of mercury given as a bolus (as in a vaccine) and environmental exposure throughout development are still two very different things, and treating autism as heavy metal poisoning can have lethal consequences.

"Vaccine load" is the idea that the normal vaccine schedule gives too many vaccines at once, thereby overwhelming a child's immune system. This concept blatantly disregards that the human body is constantly under attack from pathogens and has evolved to survive under constant attack from pathogens--the human body is more than capable of dealing even with a relatively high titre of thousands of antigens at once. Not only is the normal vaccine schedule safe, adhering to it is necessary for the maintenance of "herd immunity" and general public health.

Vaccination is one of the oldest medical procedures still in use today, and continues to be one of the most effective tools available against infectious disease. Outlining the flaws in the anti-vaccination movement would produce a blog entry far longer than I am willing to write, but there will certainly be more to follow on this topic.