PeterUbel

We live in an era of strident partisanship, with elections often decided by candidates’ attitudes towards morally and emotionally charged issues like gun control or abortion. Each presidential election seems to hinge on some set of irresolvable moral and cultural divisions, leaving the winner with at best a tenuous majority, while a firmly ensconced and angry minority plots their retribution. Tune into cable news for an hour just about any day and you will see a world divided over matters of fact. Does gay adoption harm children? Do school vouchers improve education? Does the minimum wage help low-wage workers? Each side in most of these debates appeals to their version of the facts in making their case. I am sure I am not alone in finding this discourse maddening.
But our disputes don’t always have to fester like this, in a puddle of factlessness. Because when people disagree, the right approach to facts-pursued honestly, objectively, and in genuine earnest-can resolve their disagreement. When I was a kid, arguing with my siblings at the dinner table, my parents would inevitably send us to the family room, where we kept our World Book Encyclopedia, so we could find out who was correct. Opinion didn’t win arguments in my household-facts alone were the key to success. (Of course, when the World Book failed to offer answers, we were left to utilize other, usually noisier, rhetorical weapons. But that’s a story for my memoir, not this blog.)
How is that we, as a society, can let decades pass without finding a neutral authority that will help us to figure out answers to so many important policy questions? What can we do when we are continually divided over matters of simple fact? For the beginning of an answer, I’m going to ask you to think about your heart.
The beating of your heart depends on the precise coordination of four chambers. The top two chambers, the atria, collect blood from the body and gently push this blood through to the lower, stronger chambers of the heart, the ventricles. In doing so, these two atria must coordinate their movement by sending out electrical impulses. The electricity starts up in the atria, causing those small chambers to push blood into the ventricles, by which point the electrical impulses have reached these larger muscles, spurring them on to eject the blood out into the rest of the body.
Should the electrical system in your heart go haywire, you could die from what us doctors call a cardiac arrhythmia, as happened to the beloved political journalist, Tim Russert. In his case, Russert’s doctors had already discovered that he had a narrowing of his coronary arteries, the blood vessels that supply the heart. But they had not suspected that he was at high risk for a fatal arrhythmia.
Fortunately, many people show warning signs of such arrythmias, giving doctors a chance to correct the situation before these electrical disturbances lead to disaster.
During my training at the Mayo clinic in the late 80s, I took care of many patients suffering from chronic arrhythmias. I remember monitoring their hearts with ECG recorders, watching the electrical tracings move up and down the screen. As a medical student, I had learned to recognize each of these squiggles-the spiky-looking QRS complex and the afterthought-like T waves. Some of my patients, back then, displayed scary irregularities on their heart monitors-a pulse of electricity would burst out from a rebellious location in their atria, jumping ahead of their natural pace makers. Electricity would pulse around their hearts in backwards and sideways directions. Some people would experience one or two of these premature beats every minute. Others would experience dozens of premature beats each minute, sometimes in rapid runs of four, five or six beats.
In general, people don’t die from these short bursts of electricity. But even early in my career, I was acutely aware that those six beat runs could devolve into sixty beat runs-the kind of sustained, rapid rhythms that often prove fatal.
But what could we doctors do to prevent such a tragedy? In the first few weeks of my cardiology rotation, I was being mentored by a senior cardiologist who explained that I should prescribe a powerful new anti-arrhythmic drug for my patients, a medicine like Encainide or Flecainide. These drugs, he told me, were specifically designed to prevent electrical disturbances in the heart.
So I dutifully prescribed these drugs, and was amazed-my patients’ arrhythmias invariably retreated in shame. I would watch their heart monitors, fascinated; thirty irregular heart beats per minute would become fifteen, then five, then almost none. I had seen the value of these drugs with my own eyes, and I was a believer.
But was I right to believe? And what does any of this have to do with political partisanship?
Stay tuned for Part 4.
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In my last post, the fate of a cold-blooded killer depended on nine U.S. Supreme Court Justices who could not agree whether his death would deter potential criminals.
It is easy to understand why Supreme Court Justices, forced to make difficult judgments about highly subjective issues, so often disagree with each other. No one knows, for instance, exactly what the authors of The Bill of Rights intended when they chose the words “cruel and unusual.” Indeed, the Founding Fathers themselves may not have agreed upon what these words meant. No surprise, then, that 200 years later, Justices of the Supreme Court would disagree with each other as to whether the death penalty is either cruel or unusual.
But the Justices hearing the Gregg case were not disagreeing with each other over the meaning of these two words. They weren’t divided over some fuzzy issue of semantics or original intent. Instead, they differed with each other over a matter of fact. The judges disagreed about whether the death penalty deters crime. And Gregg’s life hinged on this disagreement, because the justices agreed that if the death penalty did not deter crime, then they would not allow Georgia to execute Gregg.
Indeed, few people on either side of the political spectrum doubt the importance of the deterrence question in deciding the legitimacy of the death penalty. For example, in the 2000 presidential debates, George W. Bush was asked whether he believed the death penalty deters crime. He responded with characteristic confidence: “I do,” he said. “That’s the only reason to be for it. I don’t think you should support the death penalty to seek revenge. I don’t think that’s right. I think the reason to support to the death penalty is because it saves other people’s lives.”
Let’s for a moment try and place ourselves in the situation those Justices found themselves in back in 1976. They did not have any definitive research they could draw upon in order to prove whether the death penalty deterred criminal activity more than alternative penalties, like life without parole. Justices aren’t scientists, after all; they are judges. And because the science of the day wasn’t up to the job, the Justices had to rely on their best judgment in guessing whether the death penalty was, in fact, an effective deterrent.
Fast forward thirty plus years, to 2008, and you will find the Supreme Court once again deciding the fate of a brutal criminal-a whole slew of them, in fact. Death row inmates in Kentucky had petitioned the Court to determine whether lethal injection was cruel and unusual punishment, because the muscle paralyzers used as a part of the drug “cocktail” could potentially mask suffering-if the prisoner’s heart wasn’t stopped by one of the other drugs, then the inmate would effectively suffocate to death, unable to even open his eyes in distress.
Once again, the court found itself divided over the question of deterrence. Antonin Scalia cited what he called “a significant body of recent evidence” which proved “that capital punishment may well have a deterrent effect, possibly a quite powerful one.” Justice Stevens vehemently disagreed: “Despite thirty years of empirical research in the area,” he wrote, “there remains no reliable statistical evidence that capital punishment in fact deters potential offenders. In the absence of such evidence, deterrence cannot serve as a sufficient penalogical justification for this uniquely severe and irrevocable punishment.”
Disheartening isn’t it? Almost forty years after the Gregg case, and the Supreme Court is still divided a matter of fact.
Is there a way out of this intellectual and political stalemate?
Stay tuned for Part 3.
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On November 23, 1973, Dennis Weaver read a disturbing article in his Atlanta newspaper. Two men were found dead in a ditch along the very same highway where he had been hitchhiking the day before. Even more disturbingly, Weaver recognized that these were the very same men who had picked him up. Weaver called the police and told them he knew the victims, and that two other men had been sharing the car with them that day. He described the men and the car to the police, and the authorities quickly went after the two suspects.
Only one of those suspects was an adult-Troy Gregg, who had been hitchhiking from Florida to North Carolina with a 16-year-old named Floyd Allen. When the police found the two suspects, Gregg admitted to killing the two men, but claimed that he had done so in self defense. But Allen, interrogated in another room, told a different story. The teenager told the police he had been sleeping in the back seat of the car when the two victims pulled over so they could take a leak-they had been drinking heavily. Earlier that night, Allen said Gregg had seen the two victims holding a large wad of cash. So when the two victims stumbled down a hill to pee, Gregg lay in wait for them by the car with a loaded gun. Without any warning, he fired three shots, waking up the now startled Allen, who saw the two victims lying on the ground. His heart racing, Allen watched as his traveling companion walked calmly over to the two fallen men and shot each one again at close range in the head, execution-style, and then just as calmly emptied their pockets of cash and walked back to the car, as if he had just completed a routine conversation with his favorite bank teller.
Confronted with the testimony of his 16 year old companion, Gregg admitted to the crime. “You mean you shot these men down in cold-blooded murder just to rob them?” the police officer asked. With an air of calculated indifference, Gregg said yes.
The jury didn’t have difficulty making their decision. They sentenced Gregg to death.
But his death at the hands of the state was far from assured. Four years earlier, the Supreme Court had commuted the death sentence of another Georgian, William Henry Furman. The Justices had concluded, at that time, that Georgia was not applying the death penalty in a predictable and fair manner-it was disproportionately executing African American defendants, for example, and people without financial resources-and therefore the death penalty qualified as “cruel and unusual punishment.”
In the intervening four years, Georgia had carefully crafted new statutes laying out precisely which crimes would qualify for the death penalty. By the time Gregg executed those two men, the Attorney General of Georgia was convinced that his state’s death penalty law would pass constitutional muster. So he wasn’t worried when Gregg’s lawyers brought his case to the U.S. Supreme Court. And in fact, the Court studied the Georgia statutes, and agreed unanimously that its death penalty law was no longer cruel and unusual in its arbitrariness. They were split, however, in their assessment of whether the death penalty itself was inherently cruel and unusual, deeply divided over the issue of deterrence. After reviewing available evidence, some justices concluded that “the death penalty undoubtedly is a significant deterrent.” But others, looking at the same evidence, vigorously disagreed, writing that the death penalty “serves no penal purpose more effectively than a less severe punishment.”
Troy Gregg’s life was in balance, then, because members of the highest court in the land could not agree whether his death would deter other potential killers from following in his footsteps.
I’ll come back to the death penalty debates in subsequent posts. In fact, over the next few weeks, I’ll post a series of linked essays laying out my preliminary vision for how we, as a society, could make better use of science in making policy decisions.
Here, after all, were nine of the smartest people in the country at loggerheads over a question that was best answered by social scientists. The consitutionality of death penalty laws hinged on whether there was good evidence that it deters crimes.
What did they decide and why?
Stay tuned for Part 2.
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