The Source of Fear

Often, it is said that face your fear, but what does facing your fear really mean? And whatever it may mean, how to go about it? To begin with, personify your fear. Talk to your fear, send it vibes of love and compassion, befriend it. The same energy that was fuelling your fear will become your strength instead. By fear, I’m referring to conditioned fears we create or harbour due to our upbringing and other social norms. Viktor Frankl, in propounding logotherapy, once wrote about a man who used to sweat a lot in public. Every time he had to speak address a group, he would start sweating profusely, which he found rather embarrassing. The anxiety that surrounded in anticipation of his perspiration would make him sweat even more. “Announce your anxiety,” Viktor advised him. “If you don’t know the audience well enough, just announce it to yourself.” A week later, the man returned to report that whenever he met anyone who triggered his anticipatory anxiety, he said to himself, “I only sweated out a quart before, but now I’m going to pour at least 10 quarts!” The result: after four years of suffering, with this single selfprompt, he was cured of it within a week. Frankl called it hyper-intention: an excessive intention to be, act or feel a certain way.… Secondly, exposing your phobia, fear or cause of anxiety helps you calm down. Announce your anxiety or its cause right at the outset rather than trying to cover it.

Source: Economic Times, 29/11/2018

Why women are less successful than men at networking

Women’s tendency to underestimate their professional self-worth and reluctance to ‘exploit’ social ties makes them less successful at networking — vital for the success at the work place, a study has found. The research, published in ‘Human Relations’, shows that it is not only exclusion by men, but also selfimposed barriers, including hesitation and gendered modesty, that prevent women from networking as effectively as their male counterparts. The study, by researchers from EBS Business School in Germany, was based on interviews with 37 high-profile female leaders in German corporations. It showed that women’s tendencies to harbour moral concerns about ‘exploiting’ social ties causes them to under-benefit from networking activities. This tendency is further exacerbated by women’s predisposition to underestimate and undersell their professional self-worth. Understanding why women are less successful at networking is vital for the development of gender equality in the work place. Talking about personal hesitation, one interviewee stated: “Women look at networks from a social point of view. They do not ask ‘How will this benefit me?’ “Men, on the other hand, focus on the opposite, placing less emphasis on personal relationships and make networking decisions for egoistic and instrumental motives,” she said. “We hope that this paper’s findings will motivate women to scrutinise their positioning in networks and encourage them to interact more proactively and less reservedly with powerful social contacts,” researchers suggested. PTI

Source: Times of India, 29/11/2018

What is moralistic fallacy in philosophy?

his refers to the fallacy of assuming that only what is morally good can be a part of nature. In other words, whatever is considered to be morally wrong is assumed to be unnatural by people committing the moralistic fallacy. For instance, it may be assumed that since violence is morally wrong, it is not a part of human nature. The moralistic fallacy is often considered to be the opposite of the naturalistic fallacy where people assume that whatever is prevalent in the natural world is also morally good by default. It is said to affect the acceptability of politically incorrect scientific research.

Source: The Hindu, 28/11/2018

A prescription for the future

While using cutting-edge technology, we need to find ways to continuously lower the cost of healthcare

The world as we know it is changing so fast and so much. Global mega-trends only reinforce this fact. The Internet has taken over our lives, smartphone penetration is growing rapidly, demographics are evolving. For the first time, in 2019, millennials (born between 1981 and 1996), who feel fully at home in a digital world, will overtake the population of baby boomers. There are dramatic lifestyle and behavioural changes occurring every day, with strong implications for the future of our planet and its inhabitants.

Impactful changes

Healthcare is no stranger to change — in fact, the most impactful transformations in human life have happened in healthcare. Time ’s cover three years ago showed the picture of a child with the headline, “This baby could live to be 142 years old”. That is the extent of the breakthrough in longevity that modern medicine has been able to achieve. Healthcare in India too has been transformed over the last three decades, and as members of this industry, we can be proud of how far we’ve come in terms of improved indices on life expectancy, infant mortality, maternal deaths and quality of outcomes.

But we cannot rest on these achievements now, because the pace of change is still scorching, and is fundamentally altering disease patterns, patient risk profiles and their expectations. Information technology and biotechnology are twin engines, with immense potential to transform the mechanics of care delivery, the outcomes we can achieve and, above all, the lives we can touch and save.

There are several examples of the kinds of impact technology and biotechnology can make on healthcare. Telemedicine has already brought healthcare to the remotest corners of the country. The use of artificial intelligence for preventive and predictive health analytics can strongly support clinical diagnosis with evidence-based guidance, and also prevent disease. From the virtual reality (VR) of 3D-printing, we are now moving towards augmented reality (AR), by which, for example, every piece of node in a malignant melanoma can be completely removed, thereby eliminating the risk of the cancer spreading to any other part of the body. Biotechnology, cell biology and genetics are opening up whole new paradigms of understanding of human life and disease, and have made personalised medicine a way of life.

Largest health scheme

So, the outlook is clear: those in healthcare who wish for status quo and for the comfort of the familiar run the risk of becoming irrelevant. And that goes for countries too. India needs to rapidly adapt to, embrace and drive change if it wishes to stay relevant in the global healthcare order.

India’s change imperative has become even more pronounced with the launch of the Pradhan Mantri Jan Arogya Yojana Abhiyan, or National Health Protection Mission (NHPM), under the ambit of Ayushman Bharat. This major shift in approach to public health addresses the healthcare needs of over 500 million Indians in the first stage through what is probably the world’s largest public health-for-all insurance scheme. The vast scale of the programme requires reimagining an innovative model which will transform healthcare delivery in the country. By leapfrogging through smart adoption of technology and using emerging platforms such as Blockchain, significant improvements are possible in healthcare operations and costs.

The private health sector is committed to support this programme, and ensure its success, because we are beneficiaries of society’s social licence to operate, and it is our responsibility to make sure this programme reaches the most vulnerable and the under-privileged, for whom it is intended. At the same time, we have a solemn responsibility to ensure that the sector is sustainable in the long term. For India to grow, healthcare as an engine of the economy needs to flourish. And the private sector, which has contributed over 80% of the bed additions in the last decade, needs to earn healthy rates of return on investment to continue capital investment in infrastructure, technology upgrades, and to have the ability to acquire top clinical talent, which can lead to differentiated outcomes. In our quest to achieve low-cost healthcare, we must not inhibit our potential for growth, nor isolate ourselves from exciting global developments.

The way forward

The prescription is clear. We need to achieve a balance between staying at the cutting edge of clinical protocols, technology and innovation and continue to deliver world-class care, while finding increasingly efficient ways of operating to continuously lower the cost of care and bring it within the reach of those who cannot afford it. This is a difficult balance to achieve, but not impossible. And when accomplished, India would have found an answer that can be an example for the rest of the world to emulate.

With clarity and focus, we can create a blueprint for the legacy we wish to build and set the trajectory for Indian healthcare for the next several decades. The decisions we make today are decisions we make for our children, a future we will create for them. Will they lead healthier lives than we do? Will they approve of our choices and actions? Are we building an inclusive and sustainable world for them? We have it in our hands to shape the winds of change we face today into the aero-dynamics that will definitively propel our collective destinies forward.

Suneeta Reddy is Managing Director, Apollo Hospitals Group

Source: The Hindu, 28/11/2018

Rulers of law

Today, institutions speak not for the rule of law, but for those who rule, unconcerned with the law.

Since May 2014, our institutions are afflicted with galloping atrophy. The war within the CBI, allegations made on oath before the Supreme Court involving corruption of high public functionaries, are not limited to one institution. The recent face-off between the RBI and the government, with the latter seeking to influence monetary policies, is fraught with danger.

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A nine-hour-long meeting of the RBI’s Central Board on November 19 resulted in a temporary truce. The misgivings expressed in the public domain by no less than the deputy governor of the RBI in a public speech may well erupt in the near future. The government’s attempt to access a part of the reserves of the RBI has been temporarily forestalled. Consider this. There are no bankers on the RBI Board and no monetary policy expert. The Board consists of a few government officials, businessmen and two new members, S Gurumurthy and Satish Marathe. Both are ideologically committed. The nature of the Board’s composition is a matter of concern. In this context, the governor of the RBI has little space for manoeuvrability. The present ceasefire may not last. In the coming months, before the 2019 Lok Sabha elections, the government may well succeed in accessing RBI’s surplus capital.

The spectre of a large section of the electronic media eulogising the prime minister on the one hand and ensuring the blanking out of news that is critical of the government on the other, suggests that the one institution that has historically kept the government on its toes and served democratic traditions, has also capitulated. The institution has also been diminished by it forsaking any semblance of neutrality.

Governors have been partisan in the past, but have not been openly party to the Union government’s agenda. The recent decision of the governor to dissolve the J&K Assembly just when the PDP staked a claim to form the government is the latest example of institutional decline. Governors have, in recent years, facilitated formation of governments at the bidding of the Union and held back clear majorities even when governments appear to be in a minority. The role of the speaker in legislative assemblies is even more disturbing. The speaker, in matters of disqualification under the 10th Schedule, acts as a tribunal. It is settled that decisions of a tribunal are open to judicial review. When speakers choose not to take decisions which are inconvenient to the ruling establishment and let years pass by without acting on legitimate complaints relating to disqualification, the whole purpose of the 10th Schedule is subverted. Then, when courts render judgments to the effect that no mandamus can be issued to the speaker even though his position is that of a tribunal, it suggests that somewhere down the line, judicial decision-making has unwittingly jeopardised the rule of law. Four distinguished judges having aired their concerns in January publicly about the threat to democracy is yet another example of the institutional malaise that has set in. Unique procedures adopted by the Supreme Court in dealing with specific cases strike a jarring note.

The bureaucracy, too, has become captive to the diktats of ideological prescriptions. Individuals are appointed in key positions with the view to ensure that the so-called “political enemies” of the established ruling class are targeted. This reflects a level of bureaucratic subservience never witnessed before. The chosen few appointed to key positions, especially within the enforcement agencies, facilitate the rot. The positions of the chief vigilance commissioner, the enforcement director, CBI and the NIA are key in upholding the rule of law. If these institutions are compromised, its very foundation is jeopardised. The leadership’s favourite few, appointed in key positions in these institutions, are a threat to democracy. This rot must be stemmed. When political opponents are targeted and those whose names figure in unimpeachable documents are not investigated, the partisan nature of such institutions tends to destroy the confidence of the lay public.

Our country’s majoritarian thrust is denigrating not just the institutions under our Constitution, but others designed to protect democratic values. The independent voice of those manning our institutions has been muffled. Consequently, they speak not for the rule of law, but for those who rule, unconcerned with the law.

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The reason for this is the unique nature of Indian democracy. When a government has absolute majority in the Lok Sabha, it does not need the support of the Opposition in matters of policy, nor can the Opposition impact the government in decision-making in any substantial way. The 10th Schedule of the Constitution has ensured that members of Parliament have no voice in decision-making. This is because any violation of the whip issued in Parliament jeopardises their membership of the House. So, even if a member of the legislature disagrees with his own government, he can neither air his views nor question his own government since the whip requires him to vote for the government on the issue in question.

This is unlike any other democracy. In the presidential form of government in the US, the president, if he is a Republican, has to work with those who dissent within his party and also reach out to members of the Democratic party to ensure that his policies pass muster both in the Senate and in the House of Representatives. This applies in equal measure if the president is a Democrat. In England too, the Conservative party, if holding the reins of government, has to work with both dissenters within and members of the Labour party to ensure passage of bills. However, the unique nature of Indian democracy is held to ransom by majoritarian decision-making of a few individuals at the helm of affairs which is thrust upon the party in power and consequently on the people of India.

Today, the ruling establishment does not have a majority in the Rajya Sabha. The tyranny of the majority will be unleashed if and when that happens. The battle to save the fabric of our Constitution has begun. There is no option but to succeed.

Source: Indian Express, 28/11/2018

We are challenging our evolution

We have just entered the era of designer babies with China’s first gene-edited baby. The question is whether they can use this newfound superpower in a responsible way that will benefit the planet and its people.

A Chinese scientist from a university in Shenzhen claims he has succeeded in creating the world’s first genetically edited babies. He told the Associated Press that twin girls were born earlier this month after he edited their embryos using CRISPR technology to remove the CCR5 gene, which plays a critical role in enabling many forms of the HIV virus to infect cells.

We have just entered the era of designer babies. We will soon have the ability to edit embryos with the aim of eliminating debilitating disease, selecting physical traits such as skin and eye colour, or even adding extra intelligence. But our understanding of the effects of the technology is in its infancy.

The technology is CRISPR: clustered regularly interspaced short palindromic repeats. Discovered by scientists only a few years ago, CRISPRs are elements of an ancient system that protects bacteria and other single-celled organisms from viruses, acquiring immunity to them by incorporating genetic elements from the virus invaders. CRISPRs evolved over millions of years to trim pieces of genetic information from one genome and insert it into another. And this bacterial antiviral defence serves as an astonishingly cheap, simple, elegant way to quickly edit the DNA of any organism in the lab.

Until recently, experimenting with DNA required sophisticated labs, years of experience, and millions of dollars. The use of CRISPRs has changed all that. CRISPRs work by using an enzyme — Cas9 — that homes in on a specified location in a strand of DNA. The process then edits the DNA to either remove unwanted sequences or insert payload sequences. CRISPRs use an RNA molecule as a guide to the DNA target. To set up a CRISPR editing capability, a lab only needs to order an RNA fragment and purchase off-the-shelf chemicals and enzymes— costing only a few dollars.

Because CRISPR is cheap and easy to use, it has both revolutionised and democratised genetic research. Thousands of labs all over the world are experimenting with CRISPR-based editing projects. China has taken the lead, largely because it lacks the regulations and moral constraints that other countries abide by.

In 2014, Chinese scientists announced that they had successfully produced monkeys that had been genetically modified at the embryonic stage. In April 2015, another group of researchers in China published a paper detailing the first ever effort to edit the genes of a human embryo. The attempt failed, but it shocked the world: this wasn’t supposed to happen so soon. And then, in April 2016, yet another group of Chinese researchers reported that it had succeeded in modifying the genome of a human embryo in an effort to make it resistant to HIV infection.

This transgressed a serious boundary. We know too little to predict the broader effects of altering or disabling a gene. In the 1960s, we imagined rather naïvely that as time went by, we would understand with increasing precision the role of each gene in making us what we are. The foundation of genetics for decades, once biology’s Central Dogma, was the hypothesis that each gene codes for a single protein. Knowing the correspondences, we would have tools useful not only for research but also for curing and preventing disease with a genetic basis and perhaps for augmenting human evolution.

The one-gene-one-protein Central Dogma, though it continues to pervade our common beliefs about genetics, underwent conversion when scientists realised that many proteins comprise several polypeptides, each of which was coded for by a gene. The Dogma therefore became one gene, one polypeptide. But what sounded the entire Dogma’s death knell was the discovery in the early 1970s that a single gene can code for more than one protein. The discovery that the human genome contains only about 30,000 genes to code for some 90,000 proteins brought that home; but what makes our understanding appear spectacularly inadequate is the discovery in 2000 that a single gene can potentially code for tens of thousands of proteins.

In a nutshell, we don’t know the limits of the new technologies, can’t guess what lifetime effects a single gene alteration will have on a single individual, and have no idea at all what effects alteration of genes in sperm or ova or a foetus will have on future generations. For these reasons, we have no knowledge of whether a particular modification of the human germline will be ultimately catastrophic, and no basis for considering that tampering with heritable genes can be humane or ethical.

Because of technologies such as obstetric ultrasonography, India already has a gender imbalance: for every 107 males there are 100 females. Given the disposition of parents to favour males, preference for fairer skins and higher intelligence, and even extra height and strength, there will soon be competition to create perfect children with these technologies. Except we don’t know what perfection is; intelligence and physical traits aren’t what make humans what they are, the greatest people are usually the most imperfect.

The reality is that we have arrived at a Rubicon. Humans are on the verge of finally being able to modify their own evolution. The question is whether they can use this newfound superpower in a responsible way that will benefit the planet and its people.

Vivek Wadhwa is a distinguished fellow at Carnegie Mellon University at Silicon Valley and author of Driver in the Driverless Car, how our technology choices will create the future

Source: Hindustan Times, 27/11/2018

Why Sit in Judgement?

An able king, husband and father, sent his wife to meet his brother, a rishi who lived in the forest, along with an elaborate meal. How would she cross the river? The king said, “At the river, fold your hands and say, if my husband, the king, has lived the life of a brahmachari since birth, then let this river part and make way for us.” The puzzled queen did so with utter faith and the river parted. The rishi greeted the queen and her entourage and relished the meal she got for him. The rishi blessed his sister-in-law. The queen asked the rishi how she could cross the river to return home. The sage replied, “Say, if my brother-in-law, the rishi, has maintained a perfect fast since he became a recluse, then, O river, let me pass.” Again the queen did as she was told, the river parted and they reached home. The queen then asked a minister: why was she told to say things different from the lives the two men were leading? The king was not a brahmachari and the sage was not fasting. Yet, the river parted! The minister replied, “Your majesty, never take appearances to be reality. The king has always yearned to be a recluse like his brother but had to remain king to honour his father’s wishes. The rishi did not need to eat but he did so to honour your efforts and his brother’s desire to feed him. So, neither brother was involved in their actions; they did it for nishkamya (detached, dutiful action done with equanimity) — hence, they were not bound by their actions.

Source: Economic Times, 28/11/2018