Padraig Colman

Rambling ruminations of an Irishman in Sri Lanka

Tag: received wisdom

Should we worry about cholesterol?

It has become the received wisdom that cholesterol must be reduced to prevent heart attacks and that drugs known as statins are the best way do this.

There is some crazy logic and bad science behind this. UK government heart advisor Professor Roger Boyle suggested every man over 50 and every woman over 60 should take a daily statin. This approach has been taken to ridiculous extremes with some “experts” recommending that statins be put in the water supply or be handed out with the ketchup at burger bars.[i] The American Journal of Cardiology recently published an article suggesting that statins should be offered in complimentary packets with burgers. One of the authors, Dr. Darrell Francis, stated: “It’s ironic that people are free to take as many unhealthy condiments in fast food outlets as they like, but statins, which are beneficial to heart health, have to be prescribed.” Dr Francis is supported by a grant from the British Heart Foundation.

Many doctors in the UK are insisting that statins be taken as a preventive measure even by people, including children, with low cholesterol. When I lived in London, before the financial crash, dinner party conversation invariably revolved around house prices as ageing baby boomers plotted “Ski-ing” – “Spending the Kids’ Inheritance”.

I was surprised in Sri Lanka to hear a dinner-party guest, who clearly thought herself sophisticated, unashamedly discussing her bowel movements and haemorrhoid surgery. I soon learnt that Sri Lankans of all classes were somewhere on a spectrum between health-conscious to hypochondriac. Everyone “knows their numbers” as they say in the States. A conversational gambit might be, “I have cholesterol. How high is yours?”

There was a time when I had never heard of cholesterol and my ignorance did me no harm.

Many years ago I became a small cog in the prestigious machine that is the Study of Health and Stress carried out by Professor Sir Michael Marmot at London University.[ii] I discovered that my cholesterol levels were “at the high end of the normal range”. I was given a leaflet telling me what foods I should avoid in order to reduce my cholesterol. As I was practically a vegan at that time I did not see that there was much scope to make my diet more Spartan. No-one suggested I should take any medication.

In London I was told by my doctor to avoid cashew nuts, avocadoes and prawns. In Sri Lanka I was told to eat as much of them as I could.

What is cholesterol?

Why has cholesterol become a villain? What is it anyway? As Jenifer Anniston used to say: “Here comes the science.

Everybody “has cholesterol” – without it we would die. Cholesterol is a steroidal alcohol that helps provide structure to the membranes of all animal cells, an indissoluble molecule, a natural substance produced by the liver. Living creatures incorporate cholesterol into their cell walls to make them waterproof and to protect them against injury by oxygen. This is particularly important for the normal functioning of nerves.

Cholesterol is not something we want to clear our bodies of because 70% of our brain is made of fats and cholesterol. Cholesterol circulates in the blood stream in water soluble particles called lipoproteins.

Good and Bad

Those dinner party scientists will nod sagely and tell you that there is “Good” (HDL) and “Bad” (LDL) cholesterol. High density lipoprotein (HDL) carries cholesterol from peripheral tissues in the arterial walls to the liver. From the liver it is excreted with bile. Cholesterol is transported from the liver to peripheral tissues including those in blood vessels. When cells need extra cholesterol they call for the low density lipoprotein (LDL) to deliver the cholesterol into the cell’s interior. Between 60% and 80% of cholesterol in the blood is transported by LDL.

Why then does the common wisdom condemn LDL as “bad” and deem HDL “good”?

Risk factors and cause and effect.

People who suffer from heart disease may display a number of characteristics. Among these may be a high level of LDL. It does not necessarily follow that high LDL causes heart disease. Perhaps some mental confusion has arisen because of a misunderstanding of the term “risk factor”.

Gary Younge wrote in the Guardian in another context: “Because two things are co-related it does not mean that one causes the other. Shark attacks and ice cream sales both rise in the summer. That does not mean that ice cream attracts sharks or people react to fear of sharks by eating more ice cream”.

Being overweight is a risk factor in heart disease. Losing weight lowers LDL. A sedentary life style predisposes a person to heart disease. Exercise lowers LDL. Smoking is bad for the heart. Smoking increases LDL. Stress is bad for the heart and increases LDL. If heart attacks happen more often to people who smoke, who are overweight and suffer from stress it would be wise to give up smoking, lose weight and relax.

A US study was reported in the journal Chemistry and Industry. The study found that statins given to control cholesterol could increase the numbers of people with Parkinson’s disease. People with low levels of “bad” LDL were in excess of three times more likely to have Parkinson’s than people with high cholesterol. Now, one should not conclude from this that we need to take medication to increase our LDL because that will prevent us from suffering from Parkinson’s. The fact that people who have Parkinson’s tend to have low LDL indicates that low LDL is one of the risk factors predisposing people to Parkinson’s. It does not mean that low LDL is a cause of Parkinson’s.

It would not be wise to blame LDL for heart problems and to take drugs as quick fix to attack it while carrying on with an unhealthy life style.

Good diets and bad diets

It has become received wisdom that that animal fat is bad for the heart using the analogy of clogged-up drains.The road to hell is paved with false analogies.

Is “common sense” supported by the evidence? In Kenya the Masai believe that vegetables are suitable food only for cows. They do not consume much else but meat, milk and blood. They do not have heart attacks and their cholesterol level is 50% below that of most Americans.

In 1953, Ancel Keys published a paper in which he argued that there was an upward trend in the number of deaths in the US from heart disease. He stated that five times as many Americans as Italians died from heart attacks. Using data from six countries he claimed to demonstrate a close correlation between deaths from heart attacks and total intake of animal fat. The villainous ingredient in animal fat is cholesterol.

Keys made much of the beneficial effects of a Mediterranean diet. However tasty the food might be, Keys created a myth here. In Italy, the incidence of heart attacks is 2.5 times greater in Crevalcore than in Montogiorge, even though the average cholesterol was the same. Throughout Greece the diet is similar but people who live in Corfu are 16 times more at risk of a heart attack than people in Crete.

A WHO study shows low mortality and high mean cholesterol levels in all locations in France. Dr Bernard Forette and a team of French researchers found that the death rate for old women with very low cholesterol was five times as high as that for old women with very high cholesterol. These studies do not show that high cholesterol means early death or that low cholesterol ensures longevity.

Professor Marmot did a study of Japanese immigrants in the USA. Those who became used to the American way of life but preferred Japanese food, had heart disease twice as often as those who ate high fat American food but maintained Japanese traditions. This suggests that heart disease was not caused by cholesterol but had something to do with more general aspects of lifestyle.

There is a strange tendency for studies to be distorted to support the case for lowering cholesterol when the raw data might indicate the reverse. The most blatant example of this is the study undertaken in Framingham, Massachusetts. Many of the townspeople had their cholesterol levels tested over many years. The coronary vessels of those who died were tested. The conclusion of the researchers was that cholesterol levels predicted the degree of atherosclerosis. However, only 14% of all those who died were examined. The correlation was only a weak 0.36. Almost half of those who had a heart attack in Framingham had low cholesterol. Women with low cholesterol were as likely to die as those with high levels.

The Multiple Risk Factor Intervention Trial measured the cholesterol of 300,000 middle aged American men. The researchers concluded that the risk of a heart attack for someone with a cholesterol level above 265 was 413% higher than the risk for someone with cholesterol below 170. This shocking conclusion is undermined by the brute fact that 99.4% of the 300,000 did not die of a heart attack. 98.7% of those with the highest cholesterol levels were still alive after six years. The difference in the number of deaths between those with the highest and the lowest cholesterol levels was 1%.

In the huge INTERHEART study on 30,000 subjects in 52 countries, the effect of many modifiable risk factors on heart attacks was studied. Smoking led the list, but total cholesterol and LDL were not even listed, perhaps because the outcomes were not the ones desired by some of the sponsors of the study, which included AstraZeneca, Novartis, Aventis, Abbott Labs, Bristol-Myers Squibb, King Pharma and Sanofi-Synthelabo.6

Dr Kroop, in the Netherlands, studied men who had extensive atherosclerosis and cholesterol of at least 312. All were treated with simvastatin. Half were treated with a drug that chemically removed most LDL. The researchers were confident that they could retard or reverse atherosclerosis. There was no correlation between cholesterol lowering and angiograph changes.

The most helpful book for the layperson on the history and science of all this is written by a layman, Anthony Colpo, who provides an impressively compendious synthesis of a mountain of research and provides copious notes and references so that one can check his sources.[iii]

Side Effects

There is much anecdotal evidence of side effects from statins. For example, statins have been associated with pancreatitis, tendon problems, depression, sleep disturbances, memory loss, sexual dysfunction, cataracts, osteoporosis, peripheral neuropathy, hemorrhagic stroke and rare cases of interstitial lung disease.

Dr. Beatrice A. Golomb has carved out a niche investigating side effects of statins, particularly in women, urges caution. She claims that studies so far have not demonstrated a survival benefit for women, lower-risk men and men and women older than 70.

Impaired memory and thought are more likely to have a profound effect on seniors’ independence, while muscle weakness from the medications could make them more vulnerable to the perils of falling.

I myself felt very low and disorientated when I was taking statins five years ago. I felt better when I stopped and my cholesterol reduced dramatically.

Which doctors?

“There’s a huge literature of not-very-good studies” that link statins to a variety of problems”, said Dr. Richard H. Karas, director of preventive cardiology at the Tufts Medical Center in Boston.

You can pretty much find any disease, given the millions of people taking statins,” said Dr. Gregg C. Fonarow, a professor of cardiovascular medicine at UCLA.. But when the results of randomized trials are pooled, “you don’t [usually] find statistically significant differences between the statin and the placebo.”

I threw this question open to debate on my blog at Open Salon, to which a large number of practising MDs contributed. One of my Open Salon doctors was dismissive about my citing rhabdomyolysis as a possible side effect of statins. “If you have a 50% chance of having a deadly stroke in the next year are you ‘healthy’? What if you have a 20% chance? What if you have a 10% chance? What is ‘healthy’ anyway? A better question is: ‘At what point are you willing to run the 1:10K chance of rhabdo (reversible with cessation of the drug btw) in order to reduce your chance of a debilitating stroke?… Hey, your choice. For me, between a stroke resulting in death or permanent debilitating weakness, vs a laboratory abnormality that will go away when I stop taking the drug, I know which one I’d pick. Never mind that way more people get strokes than get rhabdo from statins. I’ve seen exactly one case of statin-induced rhabdo and I-don’t-know-how-many awful strokes.” Rhabdo is a very serious condition. It occurs through trauma from natural disasters such as the Blitz and earthquakes. It also occurs in people who abuse recreational drugs. Rhabdo has recently afflicted Redskins’ defensive tackle Albert Haynesworth. Rhabdomyolysis is a significant cause of acute renal failure, and may account for as much as a quarter of the cases of this condition. Rhabdomyolysis patients who experience acute renal failure may have a mortality rate as high as 20%. The condition also causes vomiting, confusion, coma and abnormal heart rate and rhythm. Furthermore, damage to the kidneys may lead to a marked decrease or absence of urine production, usually about 12–24 hours after the initial muscle damage. It is not a straight choice between having a stroke and having rhabdomyolysis.

In the August 21 2003 issue of the American Journal of Cardiology, [iv]Dr H Brian Brewer Jr, a senior scientist at the NIH (National Institute of Health), wrote: “No cases of rhabdomyolysis occurred in patients receiving [Crestor] up to 40 milligrams”. This evades the fact that eight cases of rhabdomyolysis were reported during clinical trials of Crestor. The LA Times obtained FDA records under the Freedom of information Act. These records show that one patient got rhabdomyolysis while taking only ten milligrams. FDA records show that 78 patients got rhabdomyolysis taking Crestor during its first year on the market and two died. Baycol was withdrawn from the market after at least 31 reports of fatal rhabdomyolysis, an adverse reaction involving the destruction of muscle tissue that can lead to kidney failure. A new study by researchers from the Tufts University School of Medicine in Boston, judged Crestor to be the most dangerous of the popular cholesterol-lowering statin drugs, because of its effects on muscles and kidneys.

Whores for Big Pharma

Dr Brewer dismissed fears of side-effects. While making recommendations on behalf of the NIH Brewer was being paid by the companies that sell the drugs.

These doctors who are blasé about the effects of statins are avoiding a core ethical issue. We might accept the side effects of a drug if they are less serious than an illness that is being cured. We might accept iatrogenesis if the benefits outweigh the costs and we were really ill to start with.

All drugs act upon the liver and kidneys while passing through the body doing good work. It is a rather different matter to take iatrogenic risks with healthy people including children.

Why is low good?

Lowering cholesterol in itself might have harmful effects. Dr Joseph Mercola, writes in Huffington Post: “What if your cholesterol level is too low? Brace yourself. Probably any level much under 150 — an optimum would be more like 200. Now I know what you are thinking: “But my doctor tells me my cholesterol needs to be under 200 to be healthy.” Well let me enlighten you about how these cholesterol recommendations came to be. And I warn you, it is not a pretty story. This is a significant issue. I have seen large numbers of people who have their cholesterol lowered below 150, and there is little question in my mind that it is causing far more harm than any benefit they are receiving by lowering their cholesterol this low.”

One large study conducted by Dutch researchers found that men with chronically low cholesterol levels showed a consistently higher risk of having depressive symptoms. This may be because cholesterol affects the metabolism of serotonin, a substance involved in the regulation of your mood.

On a similar note, Canadian researchers found that those in the lowest quarter of total cholesterol concentration had more than six times the risk of committing suicide as did those in the highest quarter.

Dozens of studies also support a connection between low or lowered cholesterol levels and violent behavior, through this same pathway: lowered cholesterol levels may lead to lowered brain serotonin activity, which may, in turn, lead to increased violence and aggression.

Dr. Ron Rosedale points out: “If excessive damage is occurring such that it is necessary to distribute extra cholesterol through the bloodstream, it would not seem very wise to merely lower the cholesterol and forget about why it is there in the first place. It would seem much smarter to reduce the extra need for the cholesterol — the excessive damage that is occurring, the reason for the chronic inflammation.”

Statins’ aim is not true

Statins work by blocking 3-hydroxy-3-methylglutaryl coenzyme A reductase, an enzyme in the liver. Unfortunately statins cannot be specifically targeted on that but as collateral damage also inhibit the synthesis of many important intermediate metabolites.

Statins have been shown to deplete the body of a coenzyme known as CoQ10, a powerful ant-oxidant which is a crucial component of mitochondria and is essential to producing almost all of a cell’s energy requirements. High levels of CoQ10 are found in healthy heart tissue. Statins, by reducing CoQ10 have been shown to be linked to an increase risk of congestive heart failure which is the fastest growing cardiovascular disorder in the USA.[v] The only cure is a heart transplant.

Creating illness for profit

Sally Fallon, the president of the Weston A. Price Foundation, and Mary Enig, PhD, an expert in lipid biochemistry, have gone so far as to call high cholesterol “an invented disease, a ‘problem’ that emerged when health professionals learned how to measure cholesterol levels in the bile.

Professor Donald Light, a professor of comparative health policy at the University of Medicine and Dentistry in New Jersey, US, in a paper presented to the 105th Annual Meeting of the American Sociological Association, claims that 85% of new drugs offer few if any new benefits — but they carry the risk of causing serious harm to users.

He said the pharmaceutical market was one in which the seller knows much more than the buyer about the product, and takes advantage of this fact. “Current incentives for research produce a few drugs that substantially improve patients’ chances of getting better or avoiding death but a large number of barely innovative drugs each year…are of little benefit and consume about four-fifths of all drug costs. The incentives and institutional practices around testing and regulatory review predictably result in approvals being based on trials so biased and poorly run that no one knows how much better or worse new drugs are.” [vi]

An estimated 85% of new drugs offer few if any new benefits while having the potential to cause serious harm due to toxicity or misuse. “Sometimes drug companies hide or downplay information about serious side-effects of new drugs and overstate the drugs’ benefits,” said Professor Light.  One study of 111 final applications for approval found that 42% were missing data from adequately randomised trials, 40% were supported by flawed testing of dosages, 39% lacked evidence of clinical efficacy, and 49% raised concerns about serious adverse side-effects.

Physicians were “double agents” – promoters of the new drug, yet trusted stewards of patients’ health. When patients complain of adverse reactions, studies show that doctors are likely to discount or dismiss them, according to Prof Light.

Prof Light highlighted the marketing of statin cholesterol-lowering drugs as a good example of Pharma hype. Company-supported clinical researchers and medical writers created a global market by manipulating a complex set of relationships between heart disease and saturated fats and cholesterol had been converted into the simple message that “cholesterol kills”.

Yet two major trials of statins found little evidence that the drugs reduce the risk of heart attacks. In contrast, they showed an increased total risk of harm to health and death from the drugs despite the lowering of cholesterol levels.

One major meta-analysis, which pooled the findings of a number of studies, found that “statins were not associated with reduction in the risk of all-cause mortality”.

Another trial led by a statin manufacturer was stopped early so that adverse side-effects were not recorded. Since the first statin was launched in 1987, it has been a boon for Big Pharma. Pfizer’s Lipitor achieved sales of $10 billion a year, becoming the world’s best selling prescription drug.

This is an example of the marketing genius of the pharmaceutical industry. Why restrict your profits by selling medicine only to sick people? The market is unlimited if you target healthy people.

Cholesterol-lowering drugs now generate $25 billion a year for the drug companies. Sales have soared because of the huge increases in the number of people classified as having “high” cholesterol. In 1990, the official US guidelines for measuring high cholesterol meant that 13 million Americans “needed” statins. In 2001, the guidelines were re-written and the potential market was immediately increased to 36 million. Five of the fourteen authors of the new definition of what constituted high cholesterol had financial ties to the drug manufacturers.

In 2004, a further redefinition expanded the potential market to 40 million. Eight of the nine experts on that panel were taking money from the drug companies.[vii] Why stop there?

Why not ignore the cholesterol levels completely and give statins to everyone in the cause of prevention? The ambition of the drug companies is to market statins to everyone, even small children, whether they are at risk of heart disease or not, whether they will benefit from the drugs or not. A recommendation from an influential doctors group that some children as young as 8 be aggressively treated with cholesterol-lowering drugs has triggered debate because there are no long-term studies for children.[viii] Barbara Hutten and colleagues from the University of Amsterdam’s Academic Medical Centre randomly gave the statins or a placebo to 214 children, between eight and 18, with a genetic condition called familial hypercholesterolemia (FH), which causes very high levels of low density lipoprotein cholesterol, commonly called “bad” cholesterol, from birth onwards. Dr Hutten said: “Our data support early initiation of statin therapy in FH children, which might yield a larger benefit in the prevention of atherosclerosis later in life. In our opinion, physicians should consider statin treatment for all FH children who are eight or older.” Ultrasound scans were used to measure the wall thickness of the carotid artery in the neck – a recognised method of checking the narrowing of blood vessels. The findings, published in Circulation, the journal of the American Heart Association, showed that the earlier statin therapy was started the less the arteries thickened. The researchers say that the artery wall would grow 0.003 millimetres thicker for every year that the start of treatment was delayed.[ix] The children were treated for at least 2.1 years and the longest for up to 7.4 years. No serious side-effects were found but the trial was too small to be sure about the safety of the treatment and the researchers said further trials were necessary.

“There may be some pressure to start them on drugs to make these numbers better,” said Dr. Thomas B. Newman, an epidemiologist and paediatrician at UC San Francisco. He also worries that the acceptance of drug use would shift the focus of treatment away from diet and exercise.[x]

We have to be skeptical in our skepticism because there is also a thriving little industry of people making a living from attacking The “cholesterol myth” and pushing their own books and remedies. Witch , sorry which, doctors do we believe? I put this question on my blog at Open Salon, to which a large number of practising MDs contribute.

Many qualified doctors oppose the cholesterol conspiracy. Perhaps the pioneer was Uffe Ravnskov.[xi] The initial response to my queries was along the lines of: “Doctors have had extensive, intensive and expensive training. They also keep up with the latest research and developments. The layperson should do what the doctor says.” I asked specific questions: “Do you think that cholesterol is a serious health risk or do you agree with those other qualified medical practitioners who think that the danger from cholesterol is a myth? “Do you think that stains should be prescribed to people who have low cholesterol?”

When pressed with the argument that many well-qualified doctors seriously doubt that cholesterol is a problem at all and question the wisdom of promiscuously prescribing statins, one particular doctor, Amy Tuteur MD, abdicated from a position of lofty certainty and said it was unfair if we don’t recognise that doctors are fallible. “In other words, treatment recommendations are being issued in a state of imperfect knowledge. Therefore, they are constantly being revised. The same thing applies to statins. In order to know whether they work, who they work for, what the side effects are and what the long term consequences of statin use are, we need to have 50 years of data on millions of people. We don’t have that, and we won’t have it for decades. Only time will reveal the truth about statins, positive or negative. Until then, all of us have to muddle along with the limited (but growing) information that we have available.”

Another doctor tried to absolve doctors from any blame for the growing ineffectiveness, through over-prescribing, of anti-biotics. “We’re taught not to do that. But see how long you last when faced with a screaming parent making a scene in the ER because you won’t give her kid abx for a viral infection.”

Blame the patient

I sensed a disturbing theme emerging: blame the patient. Doctors are all-knowing and patients should do what they are told. If anything goes wrong it is the patient’s fault. However, the doctor gives in when the patient is demanding anti-biotics and that is why anti-biotics are becoming ineffective?

I consulted my friend Dr Barbara Schumm who has been practising medicine in the UK for many years. She told me: “In British medicine we have the notion of NNT which is ‘numbers needed to treat’ i.e. the number needed to take the medication to prevent one event. Usually that figure is in the hundreds. If this concept is used to explain risk, very many patients feel that they would prefer to take the chance rather than take medication every day of their lives with no clear gain. There is an element of ‘the Emperor’s Clothes’ in all of this and certainly all the vested interests in the drug industry are reluctant to be honest about their findings”.

According to the Hippocratic Oath, doctors should not perform unnecessary surgery or take unnecessary risks by prescribing treatment of dubious value and possible harm. Under the spurious banner of “prevention” possible harm is being done, anxiety is being created, resources are being misdirected and fortunes are being made. Is it ethical to spend billions on the possibility of slightly reducing heart disease in the affluent west when all over the world millions are dying from the diseases of poverty?

[i] American Journal of Cardiology, Volume 106, Issue 4 August 2010 http://www.ajconline.org/article/S0002-9149%2810%2900870-2/abstract

[ii] Study of Health and Stress, Marmot, Michael, http://www.workhealth.org/projects/pwhitew.html and http://www.ucl.ac.uk/whitehallII/

[iii] The Great Cholesterol Con, Anthony Colpo [iv] American Journal of Cardiology [v] Langsjoen, PH & AM, Biofactors, 2003

[vi] http://www.physorg.com/news201250202.html

[vii] Selling Sickness. Moynihan, Ray and Cassels, Alan, Allen & Unwin, NSW 2005.

[viii] http://articles.latimes.com/2008/jul/09/science/sci-statin9/2

[ix] http://www.independent.co.uk/life-style/health-and-families/health-news/eightyearolds-could-be-given-cholesterol-drugs-460560.html

[x] http://www.thehealthierlife.co.uk/natural-health-articles/heart-disease/statins-heart-disease-lipitor-side-effects-children-77623.html

[xi] The Cholesterol Myths New Trends Publishing Washington DC 2000. Conspiracy theorists may raise an eyebrow at the fact that the cover of Dr Ravnskov’s book is designed by Sally Fallon and she contributes a flattering blurb

Anti-Semitism and Critical Thinking

Some time ago, I wrote a post on Open Salon which used the topic of Anti-Semitism to examine various facets of critical thinking. Recent exchanges with Ajit Randeniya prompted me to revisit it.

Let me emphasise:

  • I am not an anti-Semite
  • I am not a racist
  • I have nowhere questioned the right of the state of Israel to exist
  • I have nowhere condoned the actions of the PLO, Fatah, Hamas, Hezbollah, IRA, UDA, LTTE, FARC or any other terrorist organisation you can think of.

There were  many lengthy comments on my post, many of them off-topic and many of them angry. There was a lot of to and fro, a lot of tit for tat and the main point got lost along the way.

My main purpose was to highlight  certain tendencies I had noticed during the nearly two years that I had been blogging on OS (I served almost three years before giving up). These tendencies were brought out particularly by a debate on anti-Semitism.

The particular issue was whether criticism of Israel constituted anti-Semitism. My interlocutor, whom I will here call K,  seemed to be saying that it was possible to  criticize Israel and not be an anti-Semite. However, the upshot was a third party, DL,   called me an anti-Semite merely for using the word “sneakily” about K’s shift of ground in his argument, and an Israeli citizen  called me a hate-monger for trying to conduct a rational conversation.

Tu Quoque- the Companions in Guilt Ploy

“Don’t look at me–look at them. It reduces the debate to schoolchildren in the yard pointing fingers at each other. It is childish and self-destructive.”

Defenders of Israel tend to use a category of rhetoric known to philosophers of critical thinking as tu quoque or “the companions in guilt move”. This is brought into play in order to dilute the force of an argument by demanding a spurious consistency that the arguer may not feel is germane. Some people use it  to excuse bad behaviour on the grounds that other people also behave badly. Just because many people do something that is wrong , that does not make it right or less dangerous – for example, the defence that everyone has driven while under the influence of drink. First of all not everyone really has done so and, more importantly, it would be very dangerous if everyone took that as permission to drive under the influence.

K says that he does not think criticism of Israel by itself constitutes anti-Semitism and then  goes on to widen the definition of anti-Semitism. You don’t qualify as an anti-Semite purely for criticising Israel but you do qualify if you fail to state strongly that others, particularly Arabs and  Muslims, are as bad as Israel and probably much worse.

Straw Men

Another stale old rhetorical device is  the straw man. There is this lefty, bleeding heart, NGO, do-gooder, who hates Israel and turns a blind eye to the iniquities of Arabs and Muslims who just love to kill innocent children.

K said: “I do not believe that anyone who thinks that walking into a pizza parlor with a bomb, noticing that half the people in the pizza parlor are kids and detonating the bomb anyway should be condoned under ANY circumstances has any moral authority. I will not treat such a person’s views of right and wrong as having any validity until such time as they change their view on this. What anyone else does is beside the point – this action is intrinsically always wrong on its own. Period. I do not believe that your enemy’s moral standards should determine your own.”

That is not terribly well-expressed  or lucid  but I think it means that because Palestinians blow up innocent children in  pizza parlors they have no moral authority. Notice he does not say the particular Palestinians who set off the bombs. He says Palestinians which implies that all Palestinians lack moral authority. I suspect that the moral condemnation is extended to include those who do not condemn the action. Does “moral authority” refer to the bombers or those who condone their actions or fail to condemn? The phrase is dangling somewhat at the end of the sentence. “What anyone else does is beside the point” – what does that mean? I’m stumped!

“I do not believe that your enemy’s moral standards should determine your own.” Does that mean that the bombers have allowed their enemy – Israel- to determine their conduct? Is K condemning the bombers because they are, in killing innocent children, adopting the low moral standards of Israel? Or does it mean that, just because Palestinian terrorists kill innocent children, that Israel should refrain from killing innocent children? Israel seems to have failed morally on that score.

Opinions divorced from facts or knowledge.

Voltaire said  “prejudice is opinion without judgement”. Opinion without knowledge, truth or logic can also foster prejudice.

My meta-intention was to deal with an aspect of blogging.  (It also happens in ‘real-life’.) Before I started blogging, I used to read in the Guardian Review  a weekly summary of what was going on in  the literary blogs. I was astounded to read one self-important blogger  pompously stating: “I haven’t read X’s latest book but what seems to me to be the crucial issue is…” This seemed to be saying that whatever time, effort, imagination  and literary skill poor old  X had put into his latest tome, it paled into insignificance beside the uninformed opinions of some nonentity of a blogger.

This post came out of a general dismay at people putting forward opinions without the knowledge to back them up and proceeding with specious arguments based on faulty logic and fallacious premises. I have encountered similar tactics in relation to my posts on Sri Lanka. Someone with “Progressive” in his blog name  said that he did not know much about Sri Lanka but it seemed to him that… and proceeded to accuse me of being bigoted against Tamils (while displaying his ignorance of the reality of the situation for Tamils, a subject on which I am an expert). In his view, the fact that I lived in Sri Lanka was not relevant because he believed the Sri Lanka government controlled information.

People who are blogging clearly have access to the internet. A few minutes on Google and Wikipedia should prevent basic  errors of fact.

I quoted the Cambridge philosopher, Jamie Whyte: “You are entitled to an opinion in the epistemic sense only when you have good reason for holding it: evidence, sound arguments and so on. Far from being universal, this epistemic entitlement is one you earn. It is like being entitled to boast, which depends on having something worth boasting about.”

Leaps of logic

My chief interlocutor, K,  was a decent man with whom I got on well.  I thought him misguided in his arguments about Israel. He persistently claimed that he himself is critical of many aspects of Israeli government policy and of government actions. He claims that he has no objection to people criticizing Israel and that such criticism does not, in his view, constitute anti-Semitism.

If we unpack his actual words he was saying something quite different.

K said: “For most of my life, I drew a sharp distinction between antisemitism and antizionism. Over time, however, my opinion has changed as a result of a litmus test I now use.”

“If your standards for how Israel should behave are substantially different from your standards for how other nations should behave, chances are that you’re antisemitic.”

I don’t think he really means a distinction between anti-Semitism and anti-Zionism. He seems actually to be talking about a distinction between antisemitism and criticism of Israel.

My objection to his litmus test is that he gives permission to criticize Israel only if one criticizes other culprits.

“Because there’s only one factor that really differentiates the Israelis from everyone else and we all know what it is.”

I take it that he means that Israel is Jewish and anti-Semites hate Jews therefore those who criticize Israel are anti-Semitic because it is a given that they will not criticize other  regimes.

Although he denies it (and perhaps he does not realize what he is doing) he is still saying that criticism of Israel constitutes anti-Semitism.

Israel’s right to exist

DL (with whom I got on well in other contexts) said: “The topic, as Padraig Colman framed it, is the meta-debate. His launching point, you’ll recall, is his disagreement with K as to the boundary between antisemitism and antizionism. That isn’t about Israel’s conduct; that’s about responses to Israel’s conduct.”

Another problem that occurs in discussions like this is people make false assumptions about their interlocutors. This was not a disagreement about the boundary between anti-Semitism and anti-Zionism.  That was not my point at all! That is a completely different discussion.

At one point, K said: “I make the connection and state that antizionism under those circumstances is antisemitism by another name.“

People often talk of a distinction between anti-Semitism and anti-Zionism as if the former is vile but the latter  is acceptable. I don’t think DL would approve  if I denied being anti-Semitic but proudly admitted being anti-Zionist. Wouldn’t being anti-Zionist mean that I did not recognize Israel’s right to exist? Wouldn’t  that put  me in the same box as Iran?

History

Israel uses Hamas, Fatah and Hezbollah as justification for its own violent actions. Does anyone remember Haganah, Irgun, Lehi, Palmach? These groups were official, semi-official and unofficial paramilitaries that split and reformed into different alliances in a kaleidoscopic fashion, fought with the British and against the British and, mainly, against the Arabs. Many would  class them as terrorists. Future prime ministers Menachim Begin and Yitzhak Rabin and current president Shimon Peres served in these groups. In 1946, there were 91 people, Arabs, Jews and British, killed in the bombing of the King David Hotel, 46 injured in the hotel with further casualties outside. When the King David Hotel bombing was mentioned, Chaim Weizmann started crying heavily. He said, “I can’t help feeling proud of our boys. If only it had been a German headquarters, they would have gotten the Victoria Cross.” Netanyahu described the bombing as a legitimate act with a military target, distinguishing it from an act of terror intended to harm civilians. Civilians were harmed.

Another future prime minister Ariel Sharon, was commander of “Unit 101,” an Israeli special forces unit. On October 14, 1953, in retaliation for the killing of two Israeli civilians, Unit 101 executed sixty Arab men, women, and children in the border village of Qibya. Anyone remember Shatilla? Estimates of the dead civilians vary between 800 according to international sources to 3,500 according to Palestinian sources. Robert Fisk estimated 2,000 bodies as did Israeli journalist, the late Amnon Kapeliouk in  Le Monde diplomatique : http://mondediplo.com/2002/09/08sabra. (See also articles on Sri Lanka by the estimable Padraig Colman: http://mondediplo.com/_Padraig-Colman_) In 1982, an independent commission chaired by  Irishman Sean McBride (son of WB Yeats’s muse Maude Gonne) concluded that the Israeli authorities or forces were, directly or indirectly, indubitably involved. The Israeli government established an investigation, and in early 1983 it found Israel indirectly responsible for the event, and that Ariel Sharon bore personal responsibility for the massacre for allowing the Phalangists into the camps. The UN General Assembly condemned the massacre as an act of genocide.

History and Truth

K said:

“Jews were not the only people who migrated to the area in the half century before Israel was founded and it’s a little disingenuous to assume that one population was completely indigenous while the other was completely foreign – neither contention is true.”

K and  I agreed that the territory on which the state of Israel now sits was not empty in 1948. The fact that some of the sitting tenants  were Jews is not particularly relevant. Even if, as K says, a majority were Jewish  and had been there for thousands of years – that  also is not particularly relevant.

Israeli historian Tom Segev says, in a footnote, that the term yishuv  was used because, as well as “settlement”, it meant the opposite of “wasteland”, suggesting, consciously or not, that Zionist settlers were living in a wilderness devoid of other human beings, that is, Arabs.

According to Segev, in the 1840s, “Palestine was a rather remote region of the Ottoman empire with no central government of its own and few accepted norms. Outsiders began to flock to the country towards the end of the century, and it seemed to awake from its Levantine stupor. Muslims, Jews, or Christians, a powerful religious and emotional force drew them to the land of Israel. Some stayed only a short time, while others settled permanently. Together they created a magical brew of prophecy and illusion, entrepreneurship, pioneerism and adventurism – a multicultural revolution that lasted almost a hundred years. The line separating fantasy and deed was often blurred – there were charlatans and eccentrics of all nationalities – but for the most part the period was marked by drive and daring, the audacity to do things for the first time. For a while the new arrivals were intoxicated by a collective delusion that everything was possible”.

There was huge influx of new Jewish settlers from Europe for whom room had to be found. This was bound to alter the balance. This happened even before the state of Israel was born. Segev writes: “Tens of thousands of people, most of them Jews, came from Eastern and Central Europe. Among them were courageous rebels searching for a new identity, under the influence of Zionist ideology”.

Founding father  Ben Gurion said:  “I am in favour of an obligatory transfer, a measure which is by no means immoral.” Around 800,000 Palestinians were forced into exile between 1947 and 1949 and lost their land and property.

Benny Morris and Illian Pappé confirm that it was the Israeli authorities who forced the Palestinians to flee their land through blackmail, threats, brutality and terror. Israel had been granted more than half of Palestine. The rest was to be returned to the indigenous Arabs. However, some Jews thought  the territory earmarked for Israel  too small for the millions of immigrants its leaders hoped to attract.

Moreover, 405,000 Palestinian Arabs would have lived there alongside 558,000 Jews, who would have accounted for just 58% of the population of the future Jewish state.

In 1948, Ben Gurion was able to put his relocation plan into action. In a few months, several dozen massacres and summary executions were recorded; 531 villages out of a thousand were destroyed or converted to accommodate Jewish immigrants; eleven ethnically mixed towns were purged of their Arab inhabitants.

On Ben Gurion’s instructions, all 70,000 of the Palestinian inhabitants of Ramleh and Lydda, including children and old people, were forced from their homes at bayonet point in the space of a few hours in mid-July 1948.

Yigal Allon and the future prime minister, Yitzhak Rabin, ran the operation. Numerous refugees died of exhaustion en route, as they were driven towards the Transjordanian border.

There had been similar scenes in April 1948 in Jaffa when 50,000 of its Arab citizens had to flee, terrorised by particularly intense artillery bombardment from the Irgun, a militant, some might say terrorist, Zionist organisation.

In total 750-800,000 Palestinians were forced into exile between 1947 and 1949 and lost their land and property.

Avi Shlaim, a fellow of St Anthony’s College, Oxford, and author of The Iron Wall: Israel and the Arab World (Allen Lane and WW Norton, 2000) has demolished yet another myth: that of an Israel devoted to peace but confronted with belligerent Arab states bent on its annihilation. Shlaim recognises the legitimacy of the Zionist movement and of Israel’s 1967 borders. “On the other hand,” he says, “I entirely reject the Zionist colonial project beyond that border.”

Truth Matters- National Myths

In their book Why Truth Matters Ophelia Benson and Jeremy Stangroom write:

“History is not simply a narrative about the past; it is a research-driven form of empirical enquiry. Mythic or invented or ‘wishful’  history is thus not history at all, but a different thing – a branch of literature or story-telling. History is not propaganda, myth-making or a self-esteem inflation device, though it has often been pressed into service for those tasks. History is highly interpretative, to be sure, but it is always, when done properly, grounded in evidence. The questions are empirical ones, and the interpretation is of evidence, not of daydreams or fantasies. There has been quite a lot of glorious past-invention in the name of history recently”.

It seems that to found and sustain a nation, “glorious past-invention” is essential. Benedict Anderson has dealt better than I, with my limited powers, can with the “imagined communities” that are nations. The philosopher AC Grayling has written: “Nations are artificial constructs, their boundaries drawn in the blood of past wars. And one should not confuse culture and nationality: there is no country on earth that is not home to more than one different but usually co-existing culture. Cultural heritage is not the same thing as national identity”.

Shlomo Sand, a professor at Tel Aviv University, has argued that the Jews are neither a race nor a nation, but ancient pagans – genetically,  in the main Berbers from North Africa, Arabs from the south of Arabia, and Turks from the Khazar empire – who converted to Judaism between the fourth and eighth centuries CE. He believes that the Palestinians are probably descended from Hebrews who embraced Islam or Christianity.

Sand was quoted in Haaretz. He   was pessimistic about how his work would be received in Israel: “There was a time when anyone who claimed that the Jews had a pagan ancestry was accused on the spot of being an anti-Semite. Today, anyone who dares suggest that the Jews have never been, and still are not a people or a nation is immediately denounced as an enemy of the state of Israel.”

I have written about nationalist myths in greater depth at:

https://pcolman.wordpress.com/2011/07/15/a-nation-once-again-%E2%80%93-invention-and-amnesia/

Confusion between explanation and approval

DL: “I am referring here to your extended list of episodes of Jewish violence against Arabs, whose contextual import you left dangling before readers, thus inviting them to fill in the blank with respect to Arab violence against Jews.”

What DL left dangling is whether he defends the listed acts of violence against Palestinian civilians. I ask him plainly .”Do you deny that  acts of violence such as those listed were carried out in the furtherance of the establishment of the state of Israel?”

I hereby state  quite plainly that I do not believe that acts of violence against Palestinians by Jews justifies the blowing up of Jewish children in pizza parlors.

The actions of the Jewish paramilitaries have a bearing on the current situation and help to explain Palestinian discontent.

When I tried to explain in another article how Tamil militant separatism took hold in Sri Lanka and described Tamil grievances, I was condemned by some as a terrorist sympathiser. Explanation is not the same as justification or approval. I wrote: “Where is the proportionality between unfair university admission quotas and a thirty year war and 100,000 dead? What was the connection between discrimination against Tamils and extortion and drug trading? How did the Sinhala-only language policy lead to the assassination of Tamil politicians and the maiming of small children? How can a recurrence of such conflict be prevented?”

Disagreement is not the same as censorship

I have encountered this in real life as well as on blogs. People with whom one disagrees proclaim their rights under the first amendment. If I tell  someone I think they are  wrong they can get back and tell me how I am wrong. Disagreeing is not a form of control. I have enough trouble controlling myself without trying to control anybody else.

Someone else commented:  “Out in big boy blog world, bloggers are always challenging each other’s opinions and writing. The idea that all criticism is attacking another person , that only praise is allowed, is just idiotic.”

DL  ‘whinged’ about me accusing him of stifling debate by promiscuous use of the epithet “anti-Semite”. This is a sticks and stones kind of thing; this is not censorship in the extreme sense of having an iron-spike shoved into one’s brain through the eyeball. At the very least, though, it is a serious devaluation of the currency of language. It will not make me shut up but more timid souls might be reluctant to participate for fear of being unjustly accused of the horrible evil of anti-Semitism. Shame on you, DL!

Debasing the currency of language.

My feeling was that  K seemingly gave permission to criticize Israel and then withdrew it. I said that he had ‘sneakily’ changed his  ground. Perhaps I  should have said something about sleight of hand, or prestidigitation. DL  seemed to call me an anti-Semite for using the word ‘sneakily’. He changed his ground a little when I challenged him. He  said: “At the very least, I’d think that one would want to be highly conscious of the language one chooses when addressing topics as sensitive to Jews as antisemitism. Is Padraig an antisemite? I have no way of knowing, but I do know now that he is willing to toy with rhetoric that dances right up to the edge — and he is too clever a writer not to know just what he was doing.”

I sought further clarification and he told me: “’Sneakiness’ is part of the standard antisemitic stereotype of Jews, whether you like it or not. You are far too sophisticated to pretend unawareness. I don’t assert that you ‘must’ be an antisemite on this basis. I call it out as evidence of a willingness on your part to play around with some decidedly ugly rhetoric. Own it or not, but you deserved to be called on it.”

I honestly did not know that I could be seen as  employing a stereotype. When I said I had never been called an ant-Semite before he said: “You haven’t been called one now. I’m inclined to reserve my accusations of antisemitism for cases where the evidence is strong. I was quite clear in what I was accusing you of: rhetorically toying (flippantly, as you put it) with ugly stereotypes. Really, if you find it so wounding to be charged with such a thing, the simplest way to avoid such a charge is not to do the thing.”

I was not “rhetorically toying (flippantly, as you put it) with ugly stereotypes” I was flippantly using the word “sneakily”  without the slightest awareness that it was a stereotype that would offend a Jew. The particular Jew that I was addressing has not told me that he was offended, although we have had many friendly exchanges.

As soon as DL  suggested that the word was offensive to him,  I deleted it and told him so and asked him if he was happy. He replied: “Yes and no. Deleting what you describe as the inessential ‘sneakily’ in effect acknowledges my assessment of it as gratuitous, so, yes. But you also strenuously resist acknowledging the initial offense itself, so, no. Even Joe Biden had to acknowledge that his clumsy characterization of then candidate Barack Obama as ‘clean’ strayed into very dicey territory, whether he meant it to or not.”

Can’t do right for doing wrong!

As GB Shaw said to Zionist David Eder: “I cannot explain my position to you. There is something inherent in your germ-plasm which makes you congenitally incapable of understanding anything that I say. I have explained in writing over and over and over and over and over and over and over and over and over  and over and over  and over and over and over and over and over and over and over and over and over with the most laborious lucidity.”

K and I agreed that analogies can be misleading and even dangerous. I’m going to try one anyway. Back in the last century, I worked for the Department of Health in London in the area of child protection. The leading charity in the field conducted a number of shock horror campaigns to raise public awareness of the problem of the sexual abuse of children, to raise its own profile and to raise funds. According to the “evidence” the charity presented it seemed that just about everybody had been a victim of sexual abuse as a child.

This strategy was not helpful. Ordinary members of the public were surprised by the statistics. A lot of people thought, “I never experienced sexual abuse as a child and I don’t know anyone who has.” The charity seemed to be blaming the government for not doing more to curb the incidence of abuse. Ministers were not pleased because the charity depended for its existence on an annual grant of millions of pounds of taxpayers’ money as well as further grants for a number of one-off projects. Not surprisingly we began to look at the raw data. Members of the public thought sexual abuse meant rape and sodomy. We discovered that the charity had widened the definition to include accidental exposure to soft porn, inappropriate language, flashers in the park and loving relationships between teenagers who were legally below the age of consent. The currency was devalued.

Child abuse is evil. Racism is evil. The Israeli citizen said: “it puzzles me why people focus so much on questioning the Jew and his Land?” I am not doing that. “Don’t take us back to the Inquisition or the Krystall Nacht. That is regressive and not progressive.” “Anti-Semitism came and stayed.” If he is  saying that anti-Semitism still survives, I agree. How does one define anti-Semitism? Neo-Nazi parties are on the rise all over Europe. I did my bit campaigning against them in England by taking part in Anti-Nazi League marches and supporting the organization Searchlight which took great risks investigating and exposing fascist thugs. The National Front became very scary in England during the 70s (the play Destiny by David Edgar whom I knew at university was produced at the National Theatre to great acclaim). Today the British National Party has representatives in the European Parliament. I do my bit to counter the forces of racism in Sri Lanka.  Anti-Semitism is evil. Do not devalue the currency of language by absurdly widening the definition of anti-Semite or racist to include me.

What to do?!

Prime Minister Netanyahu  published  a book in 1993 called A Place among the Nations. In it he wrote that Israel had made enough concessions, by which he meant that it had abandoned its claim to Jordan which he believes should have been part of Israel. He repeatedly compares  Palestine’s  hopes for statehood with Nazism because  claiming territory for such a state resembles Hitler wrenching  Sudetenland out of Czechoslovakia. Israel’s withdrawal from the West Bank would be accepting a “ghetto state” within “Auschwitz borders”.

Peter Beinart argues in the NYRB that the current coalition government is the result of trends that have come to characterize contemporary Israeli society: ultra-Orthodoxy is growing, the settler movement is becoming more radical and more influential in the government and the civil service and the army,  Russian immigrants are prone to anti-Arab racism. 77% of recent Russian immigrants support encouraging Arabs to leave the country. More than 80% of religious Jewish high school students would deny Israeli Arabs the right to be elected to the Knesset.

http://www.nybooks.com/articles/archives/2010/jun/10/failure-american-jewish-establishment/

and Abraham Foxman’s response:

http://www.nybooks.com/articles/archives/2010/jun/24/failure-american-jewish-establishment-exchange/

Acceptance that Palestinians have a right to stay and that settlements should be dismantled might would be a good basis for working out a solution for the future but what is being done? Many do want to expel the Palestinians and the settlers are radically recalcitrant. I am not arguing that the state of Israel should be destroyed,  but its own actions may not help its survival. The Roman Empire once seemed indestructible, as did the British. I remember my history teacher saying that the Soviet Union had survived so many setbacks in its early days that it would probably last forever. It died at the age of 72. Apartheid South Africa seemed rock-solid until it wasn’t. Israel is two years younger than me and I feel a bit shaky. As the Buddhists say, “Anicca”, impermanence is all.

Recommended reading

I would like to recommend a few books that have helped me to clarify my thinking:

Bad Thoughts – Jamie Whyte

Critical Thinking: an Introduction – Alec Fisher

Thinking from A to Z – Nigel Warburton

A Rulebook for Arguments – Anthony Weston

The Meaning of Things – AC Grayling

Keywords – Raymond Williams

Why Truth Matters  – Ophelia Benson and Jeremy Stangroom

Lying – Sisela Bok

Truth – Simon Blackburn

True to Life – Michael Lynch

Julie MacLusky

- Author and Blogger -

HoaxEye

A fake image is worth zero words

Poet's Corner

Poems, poets, poetry, writing, poetry challenges

Casual, But Smart

Pop Culture From An Old Soul

PN Review Blog

‘The most engaged, challenging and serious-minded of all the UK’s poetry magazines’ - Simon Armitage

The Manchester Review

The Manchester Review

Slugger O'Toole

Conversation, politics and stray insights

Stephen Jones: a blog

Daoism—lives—language—performance. And jokes

Minal Dalal

Spreading resources for potential living.