Category Archives: Internet and public issues

medical information on federal websites

My blog is listed as "exemplary" on the blog

of Dr. John Gøtze, a Danish guy. At the risk of appearing to

logroll, I would heartily endorse "Gotzeblogged" (as he calls

his blog) for providing relatively technical (yet accessible) information

relevant to e-democracy and e-government.

There has been a lot of controversy about specific cases in which medical

information was changed on government websites, allegedly because

of the political or moral biases of the incumbent administration. I have

some thoughts about what to do about this problem—if it is a problem.

For now, here are the relevant facts, as far as I can tell:

In 2002, various agencies of the United States Government removed information

about condom use and abortion from their Websites, allegedly because

elected politicians favored sexual abstinence before marriage and opposed

abortion on moral or religious grounds. The National Cancer Institute

(NCI) had posted information denying a link between abortion and breast

cancer, but Rep. Henry Waxman (D-CA) objected, calling this denial "scientifically

inaccurate and misleading to the public." The NCI Website was then

changed to say (for a time) that the evidence was "inconclusive,"

until a scientific review panel required the Website to reinstate its

original language. Likewise, the Website of the Center

for Disease Control and Prevention removed its positive assessment

of condoms’ role in preventing the transmission of disease and removed

citations of evidence showing that education about condoms did not lead

to earlier or more sexual activity. After the removal of these statements

was criticized, some similar material reappeared online with the following

text added in bold: "The surest way to avoid transmission of sexually

transmitted diseases is to abstain from sexual intercourse, or to be

in a long-term mutually monogamous relationship with a partner who has

been tested and you know is uninfected."

This last sentence is literally true. However, critics disagree with

the strategy and motives that they see lying behind such statements.

Participants in this controversy divide into two camps. Some believe

that it is the responsibility of public health professionals to reduce

the spread of sexually-transmitted diseases, especially HIV/AIDS. Private,

voluntary behavior that does not transmit such diseases—or otherwise

increase morbidity and mortality—is not the business of medicine.

For this group, it seems best to advocate condom-use aggressively. Universal

condom-use is a more realistic goal than universal abstinence, and condoms

generally prevent the spread of disease. Caveats about the effectiveness

of condoms, like the one in bold on the revised website, may have the

effect of discouraging condom use. As Representative Waxman wrote in

an official complaint, the website was "carefully edited to deny

the public important information about the role condoms play in reducing

sexually transmitted diseases and pregnancies."

Another group, however, believes that there are two evils to

be minimized: (1) the transmission of dangerous disease, and (2) pre-

or extra-marital sex, which is bad in itself. Ed Vitagliano, who represents

the conservative American Family Association, said, "Science shows

that condoms are not 100 percent effective, and offer no protection

for certain sexually transmitted diseases like the human papilloma virus

and to a lesser extent chlamydia and herpes …. We fall on the side

of safety, encouraging children to wait until marriage, not only

for moral reasons, but also for scientific reasons" (emphasis

added). For this group, it makes sense to advocate abstinence, since

this is a good in itself as well as a means to avoid spreading various

diseases. Wholehearted, public advocacy of condom-use may strike such

people as tacit support for non-marital sex. They disliked the website

that was written under the Clinton Administration, seeing it as morally

biased in favor of promiscuity. The other side in the debate, however,

saw the revised text as morally biased in the opposite direction, and

the conflict led to the current text, which still offends some observers.

Sources: Robert B. Bluey "HHS Defends Its Advice

About Condoms, Abortion," www.cnsnews.com, December 27, 2002; Adam

Clymer, "Critics Say Government Deleted Sexual Material From Web

Sites to Push Abstinence," The New York Times, November 26, 2002,

p. A18; Lawrence M. Krauss, "The Citizen-Scientist’s Obligation

to Stand Up for Standards," The New York Times, April 22, 2003,

p. D3; Adam Clymer, "U.S. Revises Sex Information, and Fight Goes

On," The New York Times, December 27, 2002, p. A15.

talking about the commons at Berkeley

I’m off to California, so this blog may have to pause until April 23.

I’m going to Berkeley to give a talk at the Center for the Study of Law

and Society (co-sponsored by the Berkeley Center for Law and Technology).

My title is "Building the Electronic Commons," and I

will be discussing ideas that I have described elsewhere

on this Website, as well as some new thoughts. This is my abstract:

Legal theorists like Lawrence Lessig, Yochai Benkler, and James Boyle

have defended various versions of a "commons" theory of cyberspace.

They argue for reforms that would considerably reduce property rights,

thereby returning the Internet to its orginal state of benign anarchy

while enhancing innovation and civil liberties online. I argue that

this vision is attractive but flawed. It is politically naive, since

majorities of voters and organized special interests have incentives

to undermine such an online commons. Also, this vision promotes innovation

and negative liberty to the exclusion of other values, including democratic

ones. However, there is another understanding of the "commons"

that is just as venerable and supported by rigorous theory. This is

the notion of a commons as a voluntary nonprofit association (or network

of such associations), governed by rules. I will discuss politically

realistic ways to enhance the role of such associations in cyberspace.

The talk is scheduled for Monday from 12:30-1:45. Details

here.

a new threat to open access

Here’s a troubling technological development, pointed out by Jeff Chester

of the Center for Digital Democracy.

A company called Ellacoya provides

"network traffic control" software and hardware that

allows Internet Service Providers (ISP) to track their own customers closely

and to "enforce a very large number of policies" regarding Internet

use. The technology can, for example, limit traffic from particular sites

or categories of sites to a certain speed, or block connections altogether

to particular sites, or block connections at certain times of the day

for certain customers. The great danger is that ISPs can now speed up

connections to Websites that have paid them for special treatment, while

subtly slowing down other sites. ISPs will certainly have the incentive

to discriminate in this way if they are owned by a major content provider,

such as Microsoft or AOL Time Warner.

This means that if your favorite low-budget nonprofit seems to have a

slow Website, your ISP may actually be responsible. Also, ISPs may slow

down users who want to create and post material, rather than merely consume

it. (Ellacoya says: "Operators can easily discover their top talkers

and then set up restricted bandwidth pools for specific applications and/or

user groups during peak hours.") This kind of discrimination will

be hard to detect, so customers will not switch their ISPs to avoid it.

Yet it strikes at one of the fundamental principles of the Internet. You

should be able to share any kind of (legal) material with anyone without

an intermediary throwing obstacles in your path. Whereas overt obstacles

are easily detected and can often by bypassed, subtle discrimination poses

a serious danger.

the commons & common carriers

Some people regard the telephone network as a "commons,"

because the telephone companies have been regulated as "common carriers"

by the FCC. Today, the Commission simply defines

"common carrier" as "the term used to describe a telephone

company." But the underlying idea (which the FCC may have forgotten

in this deregulatory era) would apply just as well to railway lines or

postal services as to AT&T. A true common carrier agrees to move any

good, message, or person (depending on the medium) from anywhere in its

system to anywhere else for a price that depends only on factors that

affect its own costs, e.g., distance and weight or duration. A common

carrier may not discriminate on the basis of the content of the

message or the identity of the customer. For example, a telephone

company may not refuse to carry a phone call because of the speakers’

political views, nor may it charge different fees for different kinds

of speech. A common carrier railroad would have to carry any passenger

from any point A to any point B.

To preserve the common carrier ideal, regulations traditionally prevented

owners of communications systems from providing other services. This was

because firms that provided "content" as well as the "conduit"

would tend to discriminate in favor of their own services. For example,

if the telephone company provided 1-900 services, then it would be tempted

to give its own calls preferential treatment. For similar reasons, cable-TV

providers might give their own channels favored treatment, if they were

allowed to offer programming.

A common carrier telecommunications system is an important base for the

Internet, because it allows digital messages to be transmitted regardless

of their content, thus keeping the Internet uncensored and flexible. But

is a common carrier system a commons? We experience a classic commons

as collective property or as no one’s property—as "free."

I do not think that we view telephone lines as common property. If they

resemble a commons, it is for a combination of three reasons: (1) the

common carrier rules; (2) the very low marginal cost of each minute of

use, at least for local calls; and (3) government programs that have brought

telephones into most homes, even in rural and poor urban neighborhoods.

If any of these three conditions were missing, then the telephone system

would not feel like a commons. This is a significant conclusion because

it suggests that three types of regulations are necessary preconditions

of the Internet as we know it.

local government & online civil society

"Reduction

in Civics Classes Mirrors Decline in Youth Vote": this is a pretty

good article on youth civic engagement in yesterday’s Boston Globe.

I gave a paper today at the American

Society for Public Administration‘s Annual Conference, arguing that

local governments should support independent voluntary associations

in producing elaborate websites with databases, interactive maps,

searchable archives, researched and edited articles, structured deliberation

forums, and streaming videos. I believe that local governments can and

should help in some of these ways:

  • Providing modest grants and technical assistance. Even a total pool

    of grant money on the order of $100,000 in a county of (say) one million

    people would catalyze a lot of good work

  • Publicizing the availability of relevant information that can be put

    online in enhanced and creative forms—information such as GIS mapping

    data, historical records, and photographs.

  • Regulating local Internet service providers (ISP’s), especially cable

    companies, to ensure that they do not provide services that discriminate

    against nonprofits or against people who want to create their own websites.

    If an ISP were to block you from visiting a particular site, you would

    switch carriers (as long as there was a choice). But ISPs can discriminate

    more subtly by speeding up content from certain favored commercial sites

    and slowing down other sites, by making certain portals and search engines

    the defaults for their users, by making it artificially slow to transmit

    data, etc.

  • Creating state-of-the-art local information networks (especially wireless

    ones) that provide cheap access and do not discriminate on the basis

    of the type of content transmitted.