Suicide, assisted suicide, and physician-assisted suicide

Something like one million people each year in the United States try to kill themselves (with various levels of determination) and about four percent of them succeed. That makes suicide the 10th-leading cause of death: way ahead of homicide, and about on a par with auto accidents. About half of those attempts involve people with alcohol, tranquilizers, or opiates on board, raising the question of whether the person involved would make the same choice sober. (The answer might be “yes”: someone could decide in cold blood to kill himself and have a drink or three to steel himself to do it, or someone in chronic pain and taking opiates for it could decide that the pain is more than she wants to handle for years to come.)

In many cases, the impulse is transient; of those who survive suicide attempts, fewer than 10% eventually finish the job. Even people who, seemingly by chance, survive suicide attempts using methods that kill 95% or more of the people who try them (e.g. jumping from tall buildings or bridges, gunshots to the head) mostly don’t try it again. That suggests that most of those who succeed in taking themselves off were not acting on a steady, settled decision that life wasn’t worth living.

That being the case, preventing someone from committing suicide seems as straightforward a public-health objective and medical responsibility as preventing any other sort of sudden death.

Suicidal thoughts are even more widespread than suicide attempts. Physicians and other service providers know something – not as much as they would like, but something – about how to keep those thoughts from turning into attempts, and how to reduce the lethality of the attempts that are made. (Keeping guns out of the hands of those who might use them on themselves ranks high, since guns are especially effective means of ending one’s own life.)

Much of the burden of this work falls on psychiatrists. Those I know are proud of their many successes and intensely distressed by their occasional failures. So it doesn’t surprise me to find my friend Keith Humphreys, who teaches psychiatry, strongly opposed to having physicians – and psychiatrists above all – involved in helping people kill themselves. And published descriptions of Belgium’s legal Kevorkians are not encouraging in terms of how much care they use to avoid helping to end the lives of people who would, if they survived, be happy about it.

With all that said, I still think that people who have formed and held the view that their lives would be better shorter ought to be allowed to act on that view. The fact that much suicide is impulsive doesn’t mean that all suicide is impulsive. The fact that some people might change their minds later, either spontaneously or as the result of a medical breakthrough, doesn’t – in my view – justify the state in requiring someone who doesn’t want to go on living to do so anyway.

And the right to die ought logically to include the right to seek help in dying from a willing helper. There’s not much that can be done to prevent suicide by someone sufficiently determined and capable (physically and psychologically) of acting without help; but when someone asks for help that creates the opportunity, by surrounding the act of helping with appropriate rules, to try to screen out the cases where the intention is impulsive.

Where I agree with Keith is in thinking that the helper should not be a physician (with some exceptions I’ll get to). Physicians have the social role of protecting life and health; getting them involved in killing those who aren’t dying creates too much role tension, given that in the vast majority of cases the goal ought to be prevention.

But the real reason not to get docs involved in assisted suicide is that their professional knowledge and skill are almost completely irrelevant to the task. A physician can provide (probabilistic) information about the subject’s current and likely future health status, including mental health. “Is my depression going to get any better?” is a question a psychiatrist can try to answer. But “Would I be better off dead?” isn’t a medical question, and therefore a medical professional has no qualification for offering an opinion.

Nor is a physician needed to provide technical help, except where the laws get in the way. A breathing mask or plastic bag plus a tank of nitrogen will kill someone reliably and painlessly, and a plumber is more likely than a physician to be able to provide the requisite equipment and aid in its use. “Physician-assisted suicide” is an artifact of a world in which suicide is illegal, and some of its more reliable means (opiates and barbiturates, for example) available only with medical approval. In the special case of death by intravenous injection, skilled help is necessary simply because most of us don’t know how to mainline, even if we had the equipment and the nerve. That makes the physician the natural helper for someone who is already dying and in intense physical pain; a lethal dose of morphine or its equivalent can be given without anyone explicitly asking for a lethal dose when nothing less than a lethal dose will stop the pain.

But in the cases Keith addresses – physically healthy people who want to die because they can’t see any end to the suffering from their life situations or their somatic or mental illnesses – I’d want to keep the doctors far away. Someone in that situation ought to be allowed to register his or her decision to stop living, and – after some waiting period and approval by an actual “death panel” based on the panel’s conclusion (perhaps having taken psychiatric or other medical advice) that the subject’s intention is serious and not merely impulsive, is not made under pressure from others, and that the reasons the subject offers for the decision are not likely to materially change in the near future – be allowed access to carry out his or her intention without interference, and with help from willing helpers.

Of course this is personal. I’m now at an age where I’m going through the deaths of older relatives and friends, and every year my age gets closer to theirs. Some live well to the very end, but by no means all. I can think, without pausing, of five people close to me whose lives would have been improved by a fatal stoke months or years before the Man with the Sickle eventually showed up. I’ve spent enough endless hours in nursing homes to be absolutely certain I want to die before I land in one.

Yes, I’m worried that permission to die could evolve into social pressure to die. (See Tom Schelling’s “Strategic Relationships in Dying.”) And of course your mileage may vary. If your moral or religious principles forbid suicide, no one should try to change your mind, and you shouldn’t have to be involved in helping anyone else. But none of that seems to me an adequate reason to force continued life on those who are tired of it.

Footnote I note that Arthur Caplan, whose exquisite ethical sensibility requires that people who want to live die instead unless they can get replacement kidneys in ways that Caplan finds acceptable, also holds that people who want to die should be required to live until Caplan is satisfied there’s no “slippery slope” nearby. Seventeen people will die today in the United States waiting for kidneys, but Caplan and friends have made sure that potential living donors (you can get along just fine on one kidney) can’t be compensated for donating, so the waiting lists just keep getting longer.

In the good old days, the people who told you that innovations to alleviate human suffering (vaccination, anaesthetic-assisted childbirth, contraception, IVF) were e-e-e-e-villll and must be forbidden by law were called “bishops.” Now they’re called “bioethicists.” This represents dis-improvement in two important ways: (1) Bishops had more impressive costumes; (2) The separation of church and state doesn’t work to keep the bioethicists from imposing their professionally hyperactive consciences on the rest of us, whether we agree with them or not.

O tempora! O Associated Press!

I haven’t been following the St. Paul’s School rape case. Apparently a senior boy told his buddies he’d had sex with a freshman girl when the girl was 15; seducing freshmen seems to have been considered a badge of honor among seniors. He was charged not only with sex with a minor but also with rape; the girl claimed he forced himself on her. He asserted that everything was consensual and stopped short of full intercourse.

The jury convicted him of sex with a minor (a misdemeanor) and using a computer to seduce a minor (weirdly, a felony) but acquitted him of rape.

Rather than lamenting the sexual mores of the rising generation, I want to lament its journalistic standards.

The Washington Post, which in my youth was a newspaper, with reporters and editors, where at least some of the reporters knew something about the topics they covered and at least some of the editors tried to keep obvious falsehoods out of the paper, ran an AP story that included the following sentence:

The jury by its verdict Friday signaled they didn’t believe Labrie’s assertions that he and the girl didn’t have intercourse but also didn’t believe her contention that it was against her will.

No, no, no, no, NO!

The jury “signaled” no such thing. Assuming that the jurors were following instructions, the verdict means that they were unanimously convinced beyond reasonable doubt that the accused penetrated a minor but were not convinced beyond reasonable doubt she had not consented. They could have all gone home saying “Yeah, seems way more likely than not that he forced her, but in a swearing contest it’s hard to be morally certain.” (Of course it’s also possible that the verdict was a compromise among conflicting jurors, which is against the rules but isn’t unknown.)

The more I think about this, the angrier I get. The victim, having been victimized once by the older boy and again by the criminal justice process, now suffers a gratuitous third victimization from the AP and the WaPo, which proclaim to the entire word, indelibly, that a jury found her to be a liar, when in fact it did not.

It seems implausible that there will be a retraction – not that it would do much good – and impossible that she can successfully sue for damages, since for this purpose she’s a “public figure” under the precedent in N.Y. Times v. Sullivan.. Why should reporters, editors, and publishers be allowed to negligently damage people by failing to do their job up to professional standards of competence, and escape scott-free? Note that this isn’t a matter of opinion; what the story says about the meaning of a “not guilty” verdict is simply wrong.

Apparently the strongest evidence against the accused was his own post-incident boasting to his classmates. He and his lawyer had to claim at trial that the boy was bragging about molesting an underage girl but hadn’t actually done so. Who knows? It might even be true. But it isn’t hard to see how the jury could dismiss that claim as far-fetched while remaining in some doubt on the consent question.  

The whole thing – more carefully described in this New York Times story – makes me wonder just how far New Hampshire law allows an eighteen-year-old to go with a fifteen-year old. And, as always, I wonder what a just sentence would look like for what the defendant was convicted of doing, rather than for the even worse thing he may well have actually done.

How does Donald Trump get away with it?

My fellow chattering-class members are both amused and deeply puzzled by the Donald Trump phenomenon, as most of us were by the George W. Bush phenomenon (before all those corpses in Iraq drained it of its amusement value). How do people who spout what is, to us, obvious gibberish avoid being laughed at?

The answer, it seems to me, is as obvious as it is depressing. What all of us who think for a living really believe in, even more deeply than our most dearly held principles and prejudices, is the Principle of Noncontradiction. If one of us says X, he’s not going to turn around and say not-X (about the same aspect of the same situation) without changing his mind. [And yes, that includes Rortyans and Taoists.]

This is related to a deeper notion: that regardless of what anyone says or thinks, the real world is at least partially knowable, and that it’s therefore possible (and undesirable) to have a false belief.  [The Rortyans claim to disbelieve this, but I've never been able to understand what they're trying to say. Rorty may be wrong, but as a writer he's the opposite of slipshod.]

But that simple commitment to not talking nonsense is a minority taste, outside working hours. Yes, the minority that has that taste is in some ways dominant; since you can’t build either arguments or dams that hold water without observing it, both our lawyers and our civil engineers  observe noncontradiction in their professional lives. That applies to anyone who actually has to reason accurately – either to make stuff work or to convince sensible decision-makers – with respect to the things he or she has to reason accurately about. Even people whose stock-in-trade is deception – con artists, stockbrokers, lobbyists – have to observe the rules of arithmetic when it comes to totting up the take.  And even a young-earth creationist has to suspend his Sunday beliefs while working as a petroleum geologist.

Most of the time,  though, people aren’t at work, and much of what they think and talk about has little if any relevance to practical decisions in their own non-working lives.  Freed of the need to think rationally, most people seem to prefer the alternative. (That’s called “sports talk radio.”) And lots of them don’t mind if their politicians act the same way, especially when reciting some self-evident falsehood can be depicted as showing “loyalty” or some other virtue.

The deepest mistake is to regard someone who acts as if he doesn’t give a damn whether anything he says is true, or consistent with what he said yesterday, as stupid. That’s the mistake many liberals made (and some still make) about George W.

As far as I can tell, Donald Trump simply isn’t bothered by holding and expressing utterly inconsistent beliefs about immigration, or for that matter denying obvious facts in the face of the crowd that witnessed them. Of course Trump is going to say the Bible is the most important book to him, and of course his voters are going to expect him to say it: doing so demonstrates piety. The fact that he can’t cite a single verse doesn’t bother him; that’s in a different mental compartment. And it doesn’t much bother most of his voters, either.

From the viewpoint of civic virtue, this is horrifying; as George Bernard Shaw once said, democracy will never be a really practical form of government until the man on the street resents a fallacy as much as an insult. But it is a fact. And if we deal with it by imagining that Trump, or Trump voters, are “stupid,” we’re going to make some very bad predictions.

 

Update Of course Francis Bacon said most of this first, and better. Too bad his rather Latinate prose is just about half a century too early to be easily read by the average college student.

 

 

 

 

 

 

Fr. Jeremy Paretsky, O.P., on the knowledge of God

The last time I visited New York as a mere tourist before my promotion to citizen, I had the privilege of hearing what I – as an orthodox unbeliever – thought was a superb sermon by my old friend Jeremy Paretsky at St. Vincent Ferrer, the lovely Dominican church in the East 60s.

Now, my judgment might have been biased by friendship, but Mike O’Hare – a tough critic, and (if possible) even futher from being a Christian than I am – agreed with me that the sermon was a perfect specimen of its kind.

Jeremy was kind enough to expand the notes he spoke from into a full document, and to permit me to reproduce it below. On the off-chance that some RBC readers might not have the entire Bible memorized, I have provided the four readings for the day as a prologue.

The Texts

Job 38

Then the Lord answered Job out of the whirlwind, and said, Who is this that darkeneth counsel by words without knowledge?

Gird up now thy loins like a man; for I will demand of thee, and answer thou me.

Where wast thou when I laid the foundations of the earth? declare, if thou hast understanding, who hath laid the measures thereof, if thou knowest? or who hath stretched the line upon it? Whereupon are the foundations thereof fastened? or who laid the corner stone thereof, when the morning stars sang together, and all the sons of God shouted for joy?

Or who shut up the sea with doors, when it brake forth, as if it had issued out of the womb? When I made the cloud the garment thereof, and thick darkness a swaddling band for it, and brake up for it my decreed place, and set bars and doors, and said, “Hitherto shalt thou come, but no further: and here shall thy proud waves be stayed?”

Psalm 107

They that go down to the sea in ships, that do business in great waters; these see the works of the Lord, and his wonders in the deep. 

For he commandeth, and raiseth the stormy wind, which lifteth up the waves thereof.

They mount up to the heaven, they go down again to the depths: their soul is melted because of trouble. They reel to and fro, and stagger like a drunken man, and are at their wit’s end. Then they cry unto the Lord in their trouble, and he bringeth them out of their distresses. He maketh the storm a calm, so that the waves thereof are still.

Then are they glad because they be quiet; so he bringeth them unto their desired haven. Oh that men would praise the Lord for his goodness, and for his wonderful works to the children of men!

II Corinthians 5

For the love of Christ constraineth us; because we thus judge, that if one died for all, then were all dead:

And that he died for all, that they which live should not henceforth live unto themselves, but unto him which died for them, and rose again.

Wherefore henceforth know we no man after the flesh: yea, though we have known Christ after the flesh, yet now henceforth know we him no more.

Therefore if any man be in Christ, he is a new creature: old things are passed away; behold, all things are become new.

Mark 4

And with many such parables spake he the word unto them, as they were able to hear it. But without a parable spake he not unto them: and when they were alone, he expounded all things to his disciples.

And the same day, when the even was come, he saith unto them, Let us pass over unto the other side. And when they had sent away the multitude, they took him even as he was in the ship. And there were also with him other little ships.

And there arose a great storm of wind, and the waves beat into the ship, so that it was now full. And he was in the hinder part of the ship, asleep on a pillow: and they awake him, and say unto him, Master, carest thou not that we perish?

And he arose, and rebuked the wind, and said unto the sea, Peace, be still. And the wind ceased, and there was a great calm.

And he said unto them, Why are ye so fearful? how is it that ye have no faith?

And they feared exceedingly, and said one to another, What manner of man is this, that even the wind and the sea obey him?

How Do We Know God?

How do we know God? Is it even possible to know God?

Well, how do I know the world?

Through observation and experience, although sometimes observation and experience are misleading. The sun rises, the sun sets, but I have to learn that it is the earth’s rotation that creates the illusion. I don’t see microorganisms or blood corpuscles except with the aid of a microscope, so that only in comparatively recent times have people been aware of a vast invisible world, and the existence of sub-atomic particles have to be inferred.

And when it comes to people, how do I know another person? In dealing with other people I can evaluate experience, deduce consequences of interaction. But observation is misleading and sometimes we find what we expect to find, prejudices determining our conclusions: is that another person or a creation of my imagination?

In a general way I know another human being because we have the power to bond with one another, to love one another, to enter into one another’s lives. We are all in some ways alike, have something in common – humanity – and know the common human experiences of hope and fear, of hatred and of love.

To truly know I have to be on the inside, find what is common, what is different and what bridges the differences – our common humanity containing sometimes more than we would like to admit. If we do admit the common that
bridges our difference, we can become like the other, like knowing like.

So, back to my first question: How do we, can we know God?

Who and what am I looking for? Job thought he knew God, thought God was just as he imagined him, that he was like knowing like, but every step he took
towards the God he thought he knew increased his bewilderment, his anguish, as he went from being a man who was comfortable with the god who rewarded him for his piety to one who experienced God as raw power, even fearful, bestial, if not outright demonic in his ability to overturn an entire universe.

With each stage of his attempt to confront God Job has to deal with a god created by the human imagination, and must learn that each new “god” is not God. Only when Job strips away from his experience all that is not God,
only when he exhausts all his human knowledge and power, can he meet the voice that speaks from the depths of the unknown in the uncontrollable, ungraspable whirlwind. The voice from the whirlwind taunts, both to put down and to build up.

To know God, unlike must be remade, so God accords Job the dignity of assuming he is like God. He isn’t, but he is still in God’s image, so Job learns what he is and what he is not, when he learns who God is and who God is not.

The disciples in the boat face a similar problem: they thought that Jesus was like them, and so the disciples felt that they understood him, knew all about this man that anyone needed to know. But in a single night their world was overturned. His voice spoke into the whirlwind (the whirlwind out of which God’s voice spoke to Job), the voice which had spoken at the beginning of creation and which continues to echo down through the ages, fashioning creation ever anew.

The voice that spoke to calm the wind and the waves is the voice that makes us all a new creation. There is a great calm. Suddenly the familiar became unfamiliar – who is this?

St. Paul says, “From now on we regard no one from a human point of view; even though we once regarded Christ from a human point of view, we regard him thus no longer.”

There was a time in my life when I regarded Christ from a human point of view, indeed regarded God from a human point of view – there was
nothing to know, no one to know. And if Jesus existed, he was misinterpreted by the church that arose after him, or else he was simply crazy. In short, I recognized nothing in common with God, with Jesus. In my late teens I was first seduced by the desire to know how it was that I could reason and how it was I could insist on a moral universe, that there was really Good and Evil.

When I eventually came up against a wall, I pounded on it and demanded to know if there was anyone on the other side. The answer spoke into my chaos.
It created a new relationship, and in so doing established how alike we are: able to use reason, to create, to know good and evil. Only later did I come to accept that in Christ’s humanity we share the common knowledge of human hope and fear and suffering and love.

In Christ the part of our humanity that is unlike God is remade. Christ knows us as like knowing like, knows God as like knowing like, and puts us into a new
relationship with God. My life has never been the same. Your life has never been the same. A new way of being brought about a new way of knowing, and all of us who now exist in a new way, and know in a new way, can know the hand of God that touches us.

At the edge of our experience, when we have exhausted all strength, realized the limits of human knowledge, the limits of human life, there is where we encounter that ungraspable unknown – the ancient power speaking to us from the heart of the whirlwind. It is this power that the disciples witnessed.

Yet the marvel of God’s saving act is that all that unlimited power and knowledge and life enters into our created world as the calm after the storm. We are not given a name in answer to our question – “who is this?” – but the calm which contains the power of the Name of God, who says that from now on in Christ we have a shared history with God – it is this Name of God which enters into our very humanity in order to make us new creatures, new beings with new ways of knowing: like knowing like, man knowing man, God knowing God.

If we try to control him, we are repulsed by the terrifying storm; if we let the unknown in and let it embrace us, we enter the peace and consolation beyond all understanding.

Uber v. taxi in Brooklyn and Queens: twice as fast but no cheaper

The results of one day’s observation of taxi and Uber service in the outer boroughs of New York – the pilot phase of what is planned as a larger study – are now in.  Our riders in fact used three systems—street-hailing yellow cabs or Boro cabs, phoning NYC car ride services, and app-summoning UberX—in two randomly-selected low-income, low-crime areas, one in Brooklyn and one in Queens. 

Even ignoring the substantial number of cases where no taxi or boro-cab service was available within a thirty-minute period or where the request for a ride was refused entirely, total time from initiating the request to being in a car was half as long for Uber as for the two varieties of taxi service. That more or less matched the results from Los Angeles. By contrast with the LA results, there was no measurable difference in price.

Uber v. taxi, Round II

The BOTEC Uber-v.-taxi study in poor neighborhoods in Los Angeles, which I blogged about Monday, had some important limitations as a source of definitive answers:

1. It only covered L.A.
2. It didn’t address, e.g., service to people with disabilities.
3. It was paid for by Uber.
4. Uber had the final say on publishing the findings.

Of those, #4 was especially problematic. It’s well known that (before the FDA cracked down) pharma companies used to fund multiple safety-and-efficacy studies of new drugs and then cherry-pick which results to publish. I’m close to certain that wasn’t the case here; we only did the one study, and the idea came from us, not from Uber. Still, the question mark remains.

One way to cure that is for others to carry out similar studies. As I mentioned before, we’re happy to make our data available for re-analysis and our methods available for replication to anyone who asks.

#3 would be more of an issue had Uber been allowed to influence the study design or influence the data analysis, interpretation, or presentation. But that wasn’t the case, and the methods were entirely straightforward.

I agree with those who say that it would be better to have more studies not funded by Uber, and I’m aware of at least one independent group interested in trying. But the fact that Uber wanted the research done, while apparently the legacy taxi industry and is regulators don’t want it done, or at least don’t want it done enough to pay for it, suggests to me that everyone involved had the same intuition I did, and that was borne out by the study results: that Uber would turn out to be faster and cheaper in servicing low-income areas.

As to #2, of course service to those with disabilities is an important issue, one of many raised by the emergence of ridesharing. But no single study can cover all the issues.

The picture just got brighter with respect to both #1 (geographic scope) and #4 (the risk of cherry-picked results). Uber – motivated, no doubt, by the vote previously scheduled for tomorrow in the New York City Council on the Mayor’s proposal to cap the number of Uber drivers (but not privately-owned cars) in the name of reducing congestion – has decided to fund a similar study in New York.

That doesn’t entirely get rid of problem #1, but two research sites are better than one when it comes to generalizability.

Better yet, Uber agreed to fund the study but not claim ownership of the data, so we will be free to report whatever we find, thus avoiding problem #4 entirely.

The bad news is that, given the political calendar, data collection needed to be compressed into a single day. As I write, a small team is riding around New York, comparing UberX with both yellow taxis and what are called “boro taxis,” which operate only outside Manhattan (which accounts for 90% of all yellow-taxi trips).

So we will only be able to report pilot-scale data: a target of about 60 observations. If the differences turn out to be as dramatic and consistent in New York as they were in Los Angeles, that won’t matter, because such differences will show up clearly even on a small sample. If the differences are narrower, we may not be able to reach a firm conclusion at this stage. The plan is to do it again, more slowly, at a much larger scale.

Anyway, watch this space. The team expects to have the analysis done late tonight (California time), so there should be results up tomorrow.

Twice as fast, half as expensive

The debate about how to regulate ridesharing services such as Uber and Lyft – even whether to ban them entirely – has suffered from a surfeit of passionate assertion and a deficit of systematic data collection.

Ridesharing has been alternately criticized for its supposed mistreatment of ethnic minorities, people with disabilities, and the poor, and praised for providing those communities with an alternative to the inferior service they get from the regulated taxi industry.

A research team at BOTEC Analysis, with funding from Uber, set about to gather actual evidence about the relative performance of taxis and UberX in a sample of low-income neighborhoods in Los Angeles. (I’m on the author list, but only for editorial help: Rosanna Smart and Angela Hawken did the design and number-crunching, while Brad Rowe ran the data collection.)

The design could hardly have been simpler; we sent pairs of riders to call for taxi service or use an app to summon UberX for travel along pre-planned routes. The riders recorded how long it took – starting from the moment of picking up the phone or opening the app – before they were actually in a car and on their way, and also how much the ride cost, including a standard 15% tip for the taxi drivers and any premium charged under the Uber “surge pricing” system.

After each ride, the riders switched off; whoever took a taxi last time took an Uber next time. Our riders didn’t know that Uber had paid for the study.

The answer was clear-cut, and consistent across neighborhoods and days: summoning an UberX took less than half as long as calling for a taxi, and the trip cost less than half as much. UberX was also more reliable, with no very long wait times.

Even though Uber had no control over our data analysis or interpretation, the fact that Uber paid for the study makes some skepticism about our results natural and proper. We will happily share our data and methods with other research teams for re-analysis and replication.

It was not possible for a single study in a single city to answer all the relevant questions about ridesharing. Would the same relationship hold in other cities? Would it hold in the small number of very-high-crime neighborhoods we excluded in order to protect our riders? Would it hold after dark?

This study didn’t address questions about service for minority groups; though the neighborhoods we selected tended to have high concentrations of Latinos and African-Americans, we didn’t systematically vary the ethnicity of our riders. Nor could our study address the question of how taxis and ridesharing compare in handling riders with disabilities. And people who lack either a smartphone or a credit or debit card cannot use ridesharing at all, though they can use taxis. It would be helpful to know how often people lacking one or the other use taxis.

So this study ought to be the beginning of the scientific effort rather than the end.

But for now, anyone who asserts that ridesharing services disadvantage poor people or poor neighborhoods is making a claim that is not merely unsupported but actually contrary to the findings of the one systematic study of that question. The evidence in hand strongly suggests that UberX outperforms conventional taxis in serving low-income neighborhoods, at least in Los Angeles.

Full report here.

The higher a monkey climbs …

I have to respectfully disagree with D.R. Tucker about the Berkshire Eagle’s decision to open its op-ed column to the local Republican party, leading to the publication of this stunning bit of racist rant.

There remains a widespread belief – supported by journalistic convention – that the country currently has two mainstream political parties, holding different views but equally able to govern. That belief is false. Of course there are lots of decent Republican voters, and lots of responsible Republican elected officials. But the party as a whole is now dominated by its lunatic fringe, well represented by Mr. Nikitas. The failure of the Republicans who are actually running for President to denounce Donald Trump’s nativism is the best recent illustration of that point.

So I want to thank the Berkshire Eagle for doing a public service by helping to reveal the truth. The content of the Nikitas column deserves forthright denunciation. But the decision to print it was fully jusified. The sooner the country comes to understand that the Republican Party has become an extremist organization, the better the prospect for the sort of electoral disaster that might shock it back into respectability.

This country needs two serious parties contesting for power. But pretending that it currently has them is counterproductive.