The Elusive Nature of Medical & Other Truths - Part 1

Recently, the practice of "aesthetic medicine" in Singapore received a lot of media attention. Since I like my own face as it is, I did not really pay much attention to the specifics of the debate.

However, I did gather that some doctors in Singapore have been offering beauty treatments which are "scientifically unsubstantiated". The issue is whether these doctors should be stopped, and if so, how.

For more background, refer to these doctors' blogs - Angry Doctor; Alien Doc; and No Fear Singapore. (Notice how doctors tend to choose such unusual blogging names for themselves).

Health Minister Khaw Boon Wan has taken the position that the Ministry will step in only as far as invasive, high-risk procedures are concerned.

Thus the Ministry will not bother to intervene with non-risky beauty treatments, even if their benefits are not scientifically proven. Instead the Ministry will leave it to the medical profession to regulate itself on such matters, through organisations such as the Academy of Medicine.

In my opinion (although Angry Doctor would furiously disagree), Khaw's approach is very sensible.

I am quite confident that most, if not all, the aesthetic treatments offered by your neighbourhood HDB beautician are also "scientifically unsubstantiated". This does not mean that all these aesthetic treatments do not work.

It merely means that the treatment either does not work, or the treatment works, but has not been "scientifically" proven to work. And most of the time, the latter simply means that scientists have not bothered to do research on that particular treatment.

Which is quite alright, if the treatment does not harm or hurt you. It just means that you may have wasted some of your money on your neighbourhood HDB beautician. Your loss. Next time, try some other fruit or vegetable.

"Mr Wang is wrong. Chillis would hurt.
And durians could be downright dangerous."

Now the question then is whether we should regard doctors who provide aesthetic treatments in the same light as neighbourhood HDB beauticians.

Obviously there is some risk to the reputation of the medical profession, if many doctors go around offering beauty treatments which are non-risky but scientifically unsubstantiated to be beneficial.

The reputational risk to the medical profession would decrease, if these doctors offer beauty treatments which are non-risky and scientifically unsubstantiated, and actually work. (Happy patients don't file complaints).

But either way, the potential damage is only to (1) the medical profession's reputation, and (2) the patient's purse.

If you're not a doctor, well, frankly, who cares about Risk (1). And if you're the patient, well, Risk (2) is no different from the kind of risk you face, going to any beauty salon or parlour.

So I think Khaw is quite wise to leave it to the medical profession to regulate itself.

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How The Government Helps Singaporeans Cope With Inflation

ST March 29, 2008
SM signals a lid on govt fees for now
By Ravi Velloor

NEW DELHI - SINGAPORE may postpone increases in government charges as an inflation-taming measure.

Senior Minister Goh Chok Tong disclosed this yesterday in response to media queries on what steps the Government could take to alleviate the impact of rising prices.

He said: 'Government fees, although their going up is justified, may be restrained for a few months, postponing the increases to next year or so.

'Where it is within our control, we will try to do what we can.'

Mr Goh was speaking to the Singapore media at a press conference wrapping up a five-day visit to India.

Consumer price inflation in Singapore hit 6.5 per cent last month from a year ago. In particular, food prices have gone up sharply.

This is a little sad. The government's best idea for helping Singaporeans cope with inflation is - nothing, really.

That's right. The government's plan is just not to raise its own fees. It won't raise fees and it won't lower fees - it will leave the fees exactly as they currently are.

In other words, the government will do nothing.

Well, brilliant idea *clap, clap, clap, clap*. I wish someone would pay me a multi-million dollar salary for coming up with ideas that revolve around the concept of doing nothing.

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A Tale of Two Drugs

Which is more dangerous – alcohol or cannabis?

This is a trick question - for Singaporeans. In many other parts of the world, the correct answer is already very well-known. Meanwhile in Singapore, many people would unhesitatingly answer, “Cannabis”.

Wrong. Alcohol is more dangerous.

For an authoritative study on the topic, you can refer to this study commissioned by the UK Science & Technology Select Committee. This study compared 20 legal and illegal stimulants commonly used in Britain. The full report is here.



Heroin is the most harmful drug. Cocaine takes 2nd spot. Alcohol is rated the fifth most harmful drug. Tobacco comes in at No. 9.

Meanwhile, cannabis is rated 11th. Ecstasy comes in at No. 18. If all you knew about drugs was Singapore's drug laws, you'd never have guessed this.

You can buy alcohol and cigarettes at any supermarket. But if you were caught selling cannabis, you could die. They'd hang you.

Why am I writing about this? Just felt like it, after reading the following article in the Straits Times:

ST March 25, 2008
Drinking binge killed China woman

By Elena Chong

A CHINA woman had so much to drink at a pub that she died of acute alcohol intoxication, a coroner's court heard on Tuesday.

Ms Zhu Shaoyun, 31, had been drinking from 5pm till about 9pm at Dong Guang Entertainment Group Pub along North Bridge Road on Nov 12 last year.

In Singapore on a social visit then, she had ordered beer and a bottle of Cordonbleu from waiter Ng Wei Guang, 25.

By about 8pm, she was heavily intoxicated.

At an inquiry into her death, Station Inspector Eugene Lim Kuan Leng from Central Police Division said in his investigation report that out of goodwill, Mr Ng accompanied Ms Zhu back to Lorong 8 Geylang in a cab. She vomited on the way.

When they arrived at Lorong 8, Mr Ng noticed her foaming in the mouth and nose. She was also pale and not breathing.

Mr Ng immediately asked the cabby to take them to Raffles Hospital where she was pronounced dead at 10.50pm.

Ms Zhu's blood-alcohol level was 547mg/100ml - more than 1 1/2 times the lethal range.

SI Lim also told the court that Mr Ng had noticed that Ms Zhu, a married woman, appeared depressed, and that when he approached her, she told him to leave her alone.

Verdict: Misadventure.

Death by alcohol overdose is relatively common. In contrast, it’s practically impossible to die from a marijuana overdose. See Point 2 of the article here.

(Naturally Mr Wang is not suggesting that you go out now and buy cannabis from your neighbourhood dealer. Mr Wang is merely suggesting that you be careful how you drink your alcohol).

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Return of the Poor Little Blog

So I have an auntie who reads my blog regularly. Recently she was travelling in Hong Kong and tried repeatedly to access my blog from there. She failed, and was aghast. She feared that the Singapore government might have shut down my blog due to my recent posts about Mas Selamat.

Well, I thought this was rather funny. Singaporeans are too paranoid about the government, methinks. Then again my auntie, now retired, was a very senior civil servant. So perhaps she knows better than me.



I've not posted much this month. Come to think of it, I've not been posting much for the past few months. I'd like to be able to say that work has been keeping me busy, but the truth is that work has recently been very slow. On many days this year, I've gone to work and basically twiddled my thumbs all day. There simply hasn't been much to do at work. If the IT guys hadn't blocked access to Blogger from the office server, I'd have written enough posts in the past month to compile a book.

On the positive side, we actually managed to successfully close a few quite sizeable deals last year (the difficult market conditions notwithstanding). Therefore for 2007, I collected the biggest annual bonus (by far) of my life. Wowee. Work-wise, it was also a very interesting year and I learned a lot.

On the negative side, the continuing fallout from the US subprime crisis is hurting many areas of the banking industry quite badly. And mine is one of the most badly-hurt areas. Hence my recent thumb-twiddling. I can't say that this is a surprise. By nature I'm rather prophetic. Luckily for me, clairvoyance is a very useful tool for the formulation of Plan B's.



Anyway, back to my poor little neglected blog. Why haven't I been posting? Well, there have been various reasons. One is that I've been occupied with personal projects. Readers who've been following my blog for some time will know that I have an interest in the mysterious workings of the human mind - and recently I've just been doing a lot more exploration in the areas of meditation and self-hypnosis. Perhaps I'll blog more about this. And perhaps I won't.

"Bah. Humbug."
The other reason for my lack of posts has, surprise, surprise, got to do with my life audit. Yes, I've taken an extraordinarily long time to get it done, and in fact perhaps I should view it as an ongoing exercise rather than an annual one-off event. A big part of the life audit involves looking at different aspects of my life, and thinking about why I am doing what I am doing; should I go on doing it; and if so, the why's and how's; and are there any other things I should be doing.

As far as this blog is concerned, I've asked myself whether I should go on blogging; or whether my time and energy is better spent on other things; and if I do go on blogging, whether I should continue to write about issues where change is unlikely to occur, due to the pig-headedness of our very well-entrenched government.

Well, for now, the blogging will go on. But don't be surprised if you detect changes in theme and content.

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Politics in Cyberspace

Malaysia's recent elections will provide Singapore's PAP government with much food for thought. Among other things, the PAP will think harder about the possible influence of the Internet on future elections in Singapore:

Malaysia opposition win shows power of cyberspace
By Bill Tarrant

KUALA LUMPUR (Reuters) - Malaysia's weak opposition was up against a hostile mainstream media and restrictive campaign rules, but it can chalk up much of its stunning success in Saturday's election to the power of cyberspace.

Voters exasperated with the unvarnished support of the mainstream media for the ruling National Front furiously clicked on YouTube and posted comments with popular bloggers about tales of sex, lies and videotapes in the run-up to Saturday's election.

Jeff Ooi, a 52-year-old former advertising copywriter who made his name writing a political blog, "Screenshots" (http://www.jeffooi.com/) won a seat in northern Penang state for the opposition Democratic Action Party (DAP).

Elizabeth Wong, a human rights activist and political consultant who runs a blog (http://elizabethwong.wordpress.com/), won a state assembly seat in the central state of Selangor.

YouTube, the phenomenally popular video Web site, did as much damage as any opposition figure could hope to inflict, after netizens uploaded embarrassing videos of their politicians in action on hot-button issues.

One YouTube video in January showed ruling party MP Badruddin bin Amiruldin causing a ruckus in parliament over whether Malaysia was an Islamic state. "Malaysia is an Islamic state", he declared. "You don't like it, you get out of Malaysia!"

Muslim Malays form the majority in multi-racial Malaysia, but ethnic Chinese and Indians account for a third of the population and they deserted the ruling National Front in droves, partly in outrage over the religious debate.

SEX, SLEAZE, CORRUPTION

Another YouTube video that got wide distribution shows a rambling and incoherent Information Minister Zainuddin Maidin, in a live interview with al-Jazeera, excitedly defending a police crackdown against peaceful protesters calling for changes to the electoral process in November.

Zainuddin was one of several "big guns" in the National Front that fell to the opposition's onslaught ..... (click here for the rest).

I just received an email from one of Singapore's own newspapers. The journalist wished to interview me for an article she's working on. In view of what has just happened in Malaysia, she plans to write about the kind of political influence that Singapore's bloggers might possibly have in the next elections here.

Well, it's a matter of degree. Singapore's best-known political bloggers are nowhere as loud, noisy and passionate as Malaysia's political bloggers. But at the same time, Singapore's PAP is nowhere as incompetent and ineffective as Malaysia's BN, in running the country. So in Singapore, there really aren't so many things for bloggers to be loud, noisy and passionate about.

At the same time, the PAP is definitely much more experienced than the BN in using subtle yet effective methods to suppress dissenting voices. NTU professor Cherian George has even coined a term to collectively describe such PAP strategies - he calls it "calibrated coercion".

Meanwhile, I have just read that I am "gutless and fearful of losing my well-endowed life" and therefore the PAP need not worry about me. A rather entertaining article here.

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The Independence of the Inquiry Commission

A few days ago, Wong Kan Seng told Parliament that an "independent investigation" will be done to find out how the terrorist Mas Selamat Kastari escaped from the Whitley Road Detention Centre. Today, the Straits Times has an article about the commission of inquiry:

ST March 2, 2008
Commission of inquiry to probe JI terrorist's escape

A THREE-MEMBER Commission of Inquiry (COI) has been set up to investigate the escape of terrorist Mas Selamat Kastari from the Whitley Road Detention Centre last Wednesday afternoon.

Home Affairs Minister Wong Kan Seng vowed on Sunday that no stone will be left unturned and no effort will be spared in tracking down the Singapore Jemaah Islamiah (JI) militant chief, who is still on the run after nearly five days of extensive land, sea and air search involving more than 1,000 policemen, soldiers and Special Operation Command forces.

The three commission members appointed to carry out the inquiry are retired High Court judge Goh Joon Seng, now a member of the Council of Presidential Advisors, former Commissioner of Police Tee Tua Ba, who is now Singapore's Ambassador to the United Arab Emirates, and Dr Choong May Ling, Deputy Secretary (Security and Corporate Services) of the Ministry of Home Affairs.

The commission is expected to complete the inquiry and submit its report within a month.

.......... Mr Wong said the Commission of Inquiry would be thorough in its probe 'so that we can get an objective, balanced and comprehensive report on what took place and what we must do'.

On the commission members, Mr Wong said Mr Goh, who retired from the Supreme Court in 2000 after serving for almost 10 years, has a very good standing in the community and had contributed to the public service in various capacities since 1970.

Mr Tee, 66, who was the Police Commissioner from 1992 to 1997, 'is experienced and the knowledge he has on police operations will add value to the committee', said the Minister.

Dr Choong started her career in the Ministry of Health and has held various senior positions in different ministries before joining the Home Affairs Ministry in December 2003.

I found the above article quite disturbing. Let me elaborate.

Goh Joon Seng is a good choice. This man will know how to ask all the right questions and scrutinise the evidence with a fine-tooth comb. As a former Supreme Court judge, he has plenty of experience doing things like that.

Tee Tua Ba is also a good choice. As the former Commissioner of Police, he will have plenty of experience in security issues. Furthermore, as he has already retired from the Ministry of Home Affairs, we can be reasonably confident that he will be able to operate independently.

But Dr Choong May Ling is a bad choice. I do not know what she's doing there on the committee. For goodness sakes, the woman is the current MHA Deputy Secretary. You cannot put the current MHA Deputy Secretary on the commission and call this an "independent investigation". Clearly there would be potential for conflict of interest.

For the sake of discussion, let's just suppose that the reason why Mas Selamat managed to escape is that the detention centre was poorly-run, under-resourced and had inadequate security controls. This would indicate that the Ministry of Home Affairs has been negligent.

Do we really expect the MHA Deputy Secretary (of Security, no less) to come forward and tell us that? And effectively slap her own face in public? As well as that of her boss, Wong Kan Seng? The man who decides the size of her annual bonus?

Just to be clear, my post has nothing to do with the personal character of Choon May Ling. I know nothing about her. For all I know, she actually might be a very brave, righteous and honest person who would do a thorough investigation and speak the truth. No matter what the personal consequences may be for her.

On the other hand, by virtue of her current work capacity, Choon May Ling, in my opinion, is simply not a suitable candidate. Not for an inquiry commission that is tasked to conduct an independent investigation.

If you need an analogy, it would be like asking one of TT Durai's fellow NKF board directors to investigate the NKF scandal. Some of the directors may actually be honest and capable. But due to the potential conflict of interest, none of them are suitable persons to be conducting the independent investigation. The public would not be able to have confidence that the investigation would indeed be objectively carried out.

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