Philip Jong

Last month, renowned physicist Stephen Hawking posted the question “In a world that is in chaos politically, socially and environmentally, how can the human race sustain another 100 years?” on Yahoo! Answers. The post generated unprecedented attention from both the media and public. Earlier this month he posted a follow-up message on Yahoo! Answers to his original question.

Notwithstanding the assertion that I am in no position to compare my opinion with that of an academic and intellectual of our times, I also question the ability of humankind to survive the next millennium, given our current path of self-destructive behaviors as a civilization. The conflicts we create within our species, such as warfare and famine, as well as those we create against our habitat, such as global warming and depletion of natural resources, will only grow larger as humankind continues to expand its dominance on this planet. We blind ourselves from the long-term consequences of our actions by the short-term rewards we reap from the supposedly technological and cultural progress we achieved over time. Before we can devote ourselves to expand the human race to the reach of outer space and other stars (as Hawking claimed), we must first learn to resolve the conflicts we have already created, for otherwise our fate is sealed regardless of where the human race lives on.

Last month the unionized workers from the Toronto Transit Commission (TTC) staged an illegal strike, essentially shutting down the entire public transportation system in the city of Toronto, Canada. The strike shook up city traffic as many commuters were not forewarned about the TTC shutdown. The union defended its action by calling it an unethical lockout, while the management called it a wildcat strike. The Ontario Labor Relations Board immediately ruled against the union and served a cease and desist order to the workers to stop the illegal work stoppage. Toronto mayor David Miller also spoke against the union and stated that the workers’ action was in violation of our labor law. While the union clearly had many legitimate worker concerns such as occupational safety, the decision to stage an illegal strike without due process was a poor choice taken by the union—politically or otherwise. As public servants, TTC workers had a legal responsibility to the city to perform their job and to follow due process to resolve any outstanding dispute. Even though the strike ended soon within the same day when the union finally conceded, this ill-conceived action by the union had come at a great political cost—the cost of the much needed support from the public, who undoubtedly now holds a dimmer view of the union and its agenda.

Earlier this month the city of Toronto saw the opening of the Medicor Cancer Centre, a for-profit private clinic that provides cancer patients with medical services in return for a charged fee. Proponents claim that the clinic acts primarily as an advocate for cancer patients and its services rendered do not infringe the laws of the Canada Health Act. Opponents argue that the establishment of such a clinic merely creates a two-tier health care system that violates the spirit of universal healthcare in Canada. The center includes a team of medical physicians, naturopathic doctors, counselors, dieticians, physiotherapists, massage therapists, and other ancillary healthcare providers. To the clinic’s credit, while many (if not all) of these services are readily available to cancer patients free of charge via other means (such as through the Canadian Breast Cancer Foundation), the convenience of one-stop “shopping” and the perceived continuity of care (including 24-hour access to a physician from the center) offered by the clinic may be appealing to cancer patients who can afford such care and who do not want to be burdened by the need to arrange similar services for themselves while battling their disease. However, the autonomy of an individual to choose private over public care must be carefully balanced by the potential abuse of these alternative care pathways that may undermine the equality and rights of all Canadians to receive appropriate and timely health care. It should also be noted that the clinic does not offer essential cancer services such as chemotherapy, radiation, and surgery. As such, the public must be made aware that the care provided by this clinic is not meant as sole substitute for traditional medical care delivered to cancer patients by public healthcare. Regardless of the ethical dilemma that is raised, this is a clear demonstration that health and wealth are inescapably intertwined.

As with sitcoms, reality television has grown over the past decade to define its own genre. The origin of reality television owes not to shows such as Survivor or The Real World but to programs such as Candid Camera and others from the 1950s and earlier. While the definition of reality television is still in flux, most depict situations of so-called unscripted events that feature ordinary people in real life situations. It is attractive television programming for the networks that produce it, for the participants who take part in it, and for the audience who watch it. For the networks, these shows are often cheaper to produce as they command no television stars who demand big salaries. For the participants (some of whom are making a living appearing on these shows), these shows offer the thrills, the materialistic rewards, and their fifteen minutes of fame. For the audience, the motivations behind watching these shows are likely multiple. For some, it is the rush from watching competition between contestants unfolding in real time. For others, it is the buzz from cheering on the winners or the underdogs. Unfortunately, many viewers also watch these shows for the guilty pleasure of seeing participants failed, humiliated, or dejected by their peers. Misery loves company! The latter motivation is a sad reflection of the selfish human nature brought out by these television shows. We must not forget that there is really no reality in reality television. It is as artificially created and prescripted as other television genres. The only difference is that both the participants and the audience choose to be blinded from it, in exchange for a momentary escape from their real daily lives.

Earlier this month the city of Toronto in Canada announced a plan to implement citywide wireless hotspot access to the internet. The plan would use radio access transmitting points mounted on street lamps to provide of a blanket of WiFi (Wireless Fidelity) coverage throughout the city to the public. The service would be run by a municipal-industry partnership between the city and Toronto Hydro. Such an initiative is similar to those already introduced in several other cities in North America, including San Francisco and Philadelphia. If successful, this framework will bring Toronto one step closer to the true vision of the Global Village put forth by Marshall McLuhan in 1961. Yet, while the ideal of a Global Village has been thoroughly debated to date, the practice to which this vision should be carried out has not been properly eluded. This is because any mass exposure of new technology is prone to be abused by a few individuals attempting to take advantage of the innocent public who is less familiar with such technology. For an electronic medium such as the internet, policing against such frauds and abuses on a global scale may not likely be possible. Without due diligence to implement measures ahead that will protect the public, I am afraid that this Global Village can easily be poisoned and all of us who live in it will pay an unwanted price for a technology that we still do not fully understand.

As envisioned by many Canadians, the Conservative Party of Canada had won the national election held last month and defeated the incumbent Liberal Party of Canada. The margin of victory, however, was a small one. The party felt far short of the number of seats needed to form a majority government. With even smaller number of seats held, the newly formed Conservative minority government is leaner and structurally weaker than the Liberal minority government which it has replaced. This translates to an uphill battle for the Conservatives in power when attempting to pass any legislation, since much wheeling and dealing will be needed to curry favor from at least one of the opposition parties in order to gain enough support in the House of Commons. Many of the platform agendas raised by the Conservatives are likely not to be realized in full without compromises to satisfy the oppositions. In other words, our government will remain as a fracture democracy whose own certainty in yet another national election ahead soon.

On January 23, 2006, Canadians will cast their votes for a new federal government. For the past two months, politicians from all political parties had campaigned hard to win the confidence of their voters. The lofty promises, the murky platforms, the rumbling leaders’ debates, and the negative campaigns fill the media in attempt to influence the minds of undecided Canadians. Recent polls suggest that this election is a close race between the Liberal Party of Canada and the Conservative Party of Canada, with the New Democratic Party and Bloc Québécois trailing behind. Yet, as the Election Day draws closer, Canadians also begin to question how much changes will truly happen in the national political landscape in the aftermath that will impact on their lives. This may be the case if the election again leads to the formation of a minority rather than majority government. The fallout of this unwanted election result will be more political dealing and wheeling between the parties afterward that will only result in yet another dysfunctional government. The downside of democracy in this election may be the fact Canadians will not have an unified government that will function with an unifying agenda for the betterment of its citizens.

For some individuals who are at risk of heart disease, the Christmas holiday season can be a dangerous time for their health. Past epidemiological studies had founder higher incidences of heart attack and heart failure during the winter season as compared with the summer season. Today, Canada’s national newspaper The Globe and Mail published a story on the syndrome that was dubbed the “Merry Christmas coronary” and the “Happy New Year heart attack.” In it, the column cited studies from the US and France but also data from our own research group in Canada to which I belong. The phenomenon is of great public health interest because it remains unclear what preventable measures can be taken by the population to reduce the risks of cardiac morbidity or mortality during the winter season. While the colder outdoor temperature is an obvious potential culprit responsible for the holiday “woes” of the heart, many other environmental factors as well as the behaviours of the population are also likely to be at play. Moreover, I had suggested that it might be the response of the population to the changing environment that is more of a determinant of risk than the actual environment where the population is currently inhabited. For example, the story cited our data showing that the increase in heart attack and heart failure rates is paradoxically higher in Southern than Northern Canada, despite the fact the climate in the north is colder than the south. Future studies should help to discover the underlying causes of this winter danger and derive appropriate public health measures. In the meantime, the public should heed to the advice of the Heart and Stroke Foundation of Canada and use common sense to minimize risky behaviors that may increase the risks of having heart attack or heart failure.

Wikipedia is the poster child of public domain knowledge database. Found in 2001 by Jimmy Wales, the utilitarian goal of this “free” online encyclopaedia is to provide a platform where the “total” knowledge of humankind can be permanently recorded for prosperity. To keep up to date, this online knowledge repository can be continuously edited by anyone who chooses to contribute. With the increasing use of Wikipedia by the public, critics of Wikipedia have raised concerns about the credibility of such public domain knowledge database where no one truly polices the accuracy of the information within.

In November, the trustworthiness of Wikipedia was seriously called into question in an USA Today exposé by John Seigenthaler Sr., a former assistant of Robert Francis Kennedy, about his discovery of a false entry in the online encyclopedia in which he was implicated in the assassination of both Senator Kennedy and his brother President John Fitzgerald Kennedy. Last week, the New York Times reported the perpetrator to be Brain Chase, who entered the false information into Wikipedia as a gag directed against the eminent Seigenthaler family in Nashville where Chase lives. This single act of sabotage exposes the vulnerability of Wikipedia in that the information within can easily be falsified by anyone for unethical gains.

In contrast, the accuracy of Wikipedia on scientific information appears to fair better. In a research paper just published from the prestigious scientific journal Nature, a peer-review comparison between Wikipedia and Britannica Encyclopedia on their contents across a board range of scientific disciplines found that the difference in accuracy between the two encyclopaedias was only small. On average, a scientific entry in Wikipedia contained about four errors as compared with three errors in a scientific entry in Britannica.

The creation of a public domain knowledge base such as Wikipedia is of great benefit to humankind. With proper safeguard to ensure the accuracy of its content, further development of such database should be actively encouraged and not prematurely abandoned because of “teething” problems.

The adoption of Canada Health Act in 1984 establishes the provision of universal healthcare in providing essential medical services to all Canadians without economic or access barriers. It forbids health professionals and institutions from rendering priority medical care to individuals in return for financial compensation. For the past two decades, our universal healthcare system remains to be a pinnacle achievement by Canada in attempt to deliver efficient and cost-effective medicine. Still, the merit of public versus private healthcare has been an ongoing debate between proponents and opponents of our current system.

More recently, co-operative medicare has been promoted to be the ultimate savoir of our degenerating healthcare system, where public medical care coexists with limited priority medical care that are available to individuals who are willing to pay for “extra” service. Proponents argue that the establishment of such two-tiered system will jeopardize neither quality nor equity of medical care for Canadians. Yet, it is unclear at present how such protection can be guaranteed. In the US, variations in quality of medical care have been linked to the coexisting delivery of managed care and public care. Last month, Canadians witnessed the opening of Canada’s first private primary care centre in Vancouver, British Columbia. The Copeman Healthcare Centre offers services to primary care physicians and in-house specialists for an initial enrolment fee and an annual service charge. Last week, Vancouver’s Cambie Surgical Centre announced plans to open a for-profit surgical hospital in Ontario. As a healthcare professional myself, I believe the prima facie proof must always be the delivery of timely quality medical care to “all” people who seek such service, regardless of what healthcare system or systems may ultimately be employed. If co-operative medicare is to be instituted, the ethical ramification and resource repercussion must be thoroughly explored by all key stakeholders (not just those who may benefit) before it should be made available to Canadians.