Informed decision?

Reader question:

What does “informed decision” mean, as in “Kids can’t make an informed decision”?

My comments:

Children cannot make an informed decision….

Therefore parents must make decisions for them, is that it?

Well, first, definitions. An informed decision is a decision based on information – facts, that is.

Say you want to go watch the latest blockbuster movie imported from Hollywood. You go online to check which cinemas have it on show, what times they have it on and whether tickets are available, etc. Then you pick the cinema nearest to where you live and go directly there 20 minutes before show time. That’s an informed decision, a decision based on research – or fact finding.

If, on the other hand, you hear the movie is on and do no additional research, you may make a few mistakes and waste your precious time – supposing, of course your time is precious and you don’t have much of it to waste over movies. You may, for instance, run to a cinema only to discover it doesn’t show that particular movie or even if it shows that movie the only tickets available are for five hours later and things like that. This time, your decision is not an informed one, i.e. not one based on fact finding but merely on rudimentary hearsay.

OK, let’s return to children being unable to make an informed decision. Being children, they’re too young to know everything. They don’t have a rich pool of knowledge to draw upon when it’s time to make certain decisions. Therefore, for example, children under a certain age are not allowed to board the bus or an airplane without adult guidance.

Then, of course, one hopes that the adults involved are competent adults. Parents in Chinese families are known for having a particularly strong yen to make decisions for their children no matter their age. And some of them like to make decisions not because they are better informed but purely on the strength of them being parents. This strength comes from our rich feudal tradition, of course, and officials and bureaucrats in general all somewhat has this tendency – a tendency to make decisions for the public because they, traditionally at least, are considered parental figures to the masses under their government.

In these circumstances, one hopes that any decisions made by these parents or quasi parents are all well informed.

And that they’re all morally sound people too. For example, if a certain company is entrusted with the authority to see whether it’s feasible to build a few new dams in Southwest China among the high mountains, you hope they come to an informed decision, i.e. after informing themselves about all the pros and cons. In other words, you want them to make a decision with a view of the big picture. You don’t want them to make a decision purely for the short-term gains, gains that will guarantee, for instance, that some people – themselves included, to be sure – will be made rich. You also want them to see the impact on the eco system as a whole to the locals and even folks beyond the border in South Asia.

At least you want them to know that people talk.

This is perhaps drifting too far for you. Let’s swiftly return to the term itself – and read a few examples of “informed decision” in the media:

1. I’d given up on trying to convince people to wear a helmet while riding two-wheeled contrivances. Over the last few years we’ve seen a number of people killed while riding. Most were not wearing a helmet.

Two things changed my mind. The Sept. 28 Viewpoint featured the new Maui County president of the Street Bikers United Hawaii railing against the wearing of helmets and some new laws being considered. He trots out the argument about other activities that boils down to the old “why did you pull me over, why didn’t you pull him over?” ploy.

The second was a call from my daughter. She’s attending college in Nebraska and has purchased a bike to get around the campus. Her roommate did the same but decided against the expense of a helmet.

My daughter related the story of a crash I had a few years ago where I hit a wet spot, went down and suffered a broken clavicle, broken ribs puncturing a lung and bruised heart. Because I was wearing a helmet I suffered no head damage. The roommate took the story to heart and bought a helmet. Good thing.

She was run off the road by a car. She is, as I write this, in the emergency room. The one thing she’s not suffering from is any head injuries.

I’ll leave it to you to make an informed decision on wearing a helmet. You know how I’ll vote.

Mike Sowers, Lahaina

- Make an informed decision regarding helmet use, The Maui News, October 3, 2011.

2. In his Feb. 8 From The Hill column Larry Miller wrote that the Old Age Security is not sustainable in its present form. The reasons he gave were that the OAS was funded from general government revenues and that by 2030 there will be only two working-age Canadians for every senior. This meant that there would not be enough revenue to cover the benefits.

While the general facts may be true, I believe that Mr. Miller is not giving us enough information to make an informed decision.

On Feb. 8 the Parliamentary budget officer, Kevin Page, released a report which stated the OAS system is fully sustainable in its current form and in fact stated that it could be improved.

The reason for this is that even though the costs will increase by 2030 (to $108 billion) the size of the economy and resulting government revenues will also increase dramatically.

The current government likes to use simple numbers ($36 billion in 2010 to $108 billion in 2030) as its justification to reduce benefits. These numbers are large and scary.

The PBO uses a percentage of the gross domestic product or “size of the economy.” By his calculations the current and future cost of OAS will remain between 2.2% and 3.2 % of the GDP, or a 1% increase over 20 years.

Another report by the office of the chief actuary that I have read online, supports the PBO and predicts that the OAS costs will peak in 2030 and then decline to about 2% of GDP by 2075 as baby boomers die off.

Other news sources have quoted a 2010 report from the Finance Department as stating that the “public retirement income system is financially sustainable”.

Given this additional information, as well as numerous other sources of information online, I start to wonder why our government is not providing the public with all the relevant information on such a massive change to our public benefits.

The OAS and most other government spending comes from the general revenues and we the public must decide on the priorities for spending that money.

If we want to spend that revenue on $35 billion fighter jets that cannot function properly in the Arctic or billions more on super-prisons instead of Old Age Security, then that is our right. However, we need adequate and reliable information from our elected officials in order to make those informed decisions.

Scott Andrews, Sauble Beach

- Opinion Letters: Taxpayers need accurate information about OAS to make an informed decision, OwenSoundSunTimes.com, February 22, 2012.

3. A leading breast cancer researcher says abortion has caused at least 300,000 cases of breast cancer causing a woman’s death since the Supreme Court allowed virtually unlimited abortion in its 1973 case.

With tens of millions of abortions since the high court’s decision and research confirming abortion increases the risk of contracting breast cancer, undoubtedly a large number of breast cancer cases, caused by abortion, have occurred over the last 38 years.

Professor Joel Brind, an endocrinologist at Baruch College in New York, worked with several scientists on a 1996 paper published in the Journal of Epidemiol Community Health showing a “30% greater chance of developing breast cancer” for women who have induced abortions. He recently commented on how many women have become victims.

“If we take the overall risk of breast cancer among women to be about 10% (not counting abortion), and raise it by 30%, we get 13% lifetime risk,” Brind explains. Using the 50 million abortions since Roe v. Wade figure, we get 1.5 million excess cases of breast cancer. At an average mortality of 20% since 1973, that would mean that legal abortion has resulted in some 300,000 additional deaths due to breast cancer since Roe v. Wade.”

Brind said his estimate excludes deaths from the use of abortion to delay first full term pregnancies – a recognized breast cancer risk.

Karen Malec, the head of the Coalition on Abortion/Breast Cancer, a public awareness group, says the number of studies showing the abortion-breast cancer link continues to grow in the years since Brind’s groundbreaking 1996 analysis of the major studies at that time.

“During the last 21 months, four epidemiological studies and one review reported an abortion-breast cancer link,” she noted. “One study included National Cancer Institute branch chief Louise Brinton as co-author. We count nearly 50 published epidemiological studies since 1957 reporting a link. Biological and experimental studies also support it.”

“Experts proved in medical journals that nearly all of the roughly 20 studies denying the link are seriously flawed (fraudulent). Like the tobacco-cancer cover-up, these are used to snow women into believing abortion is safe,” Malec added.

Surgeons like Dr. Angela Lanfranchi, a Clinical Assistant Professor of Surgery at Robert Wood Johnson Medical School in New Jersey who has extensively explained how abortion increases the breast cancer risk, have seen first-hand how abortion hurts women.

In 2002, Angela Lanfranchi, MD testified under oath in a California lawsuit against Planned Parenthood that she had private conversations with leading experts who agreed abortion raises breast cancer risk, but they refused to discuss it publicly, saying it was “too political.”

As the co-director of the Sanofi-aventis Breast Care Program at the Steeplechase Cancer Center, Lanfranchi has treated countless women facing a breast cancer diagnosis. Lanfranchi was named a 2010 Castle Connolly NY Metro Area “Top Doc” in breast surgery.

In an article she wrote for the medical journal Linacre Quarterly, Lanfranchi talks about why abortion presents women problems and increases their breast cancer risk:

Induced abortion boosts breast cancer risk because it stops the normal physiological changes in the breast that occur during a full term pregnancy and that lower a mother’s breast cancer risk. A woman who has a full term pregnancy at 20 has a 90% lower risk of breast cancer than a woman who waits until age 30.

Breast tissue after puberty and before a term pregnancy is immature and cancer-vulnerable. Seventy five percent of this tissue is Type 1 lobules where ductal cancers start and 25 percent is Type 2 lobules where lobular cancers start. Ductal cancers account for 85% of all breast cancers while lobular cancers account for 12-15% of breast cancers.

As soon as a woman conceives, the embryo secretes human chorionic gonadotrophin or hCG, the hormone we check for in pregnancy tests.

HCG causes the mother’s ovaries to increase the levels of estrogen and progesterone in her body resulting in a doubling of the amount of breast tissue she has; in effect, she then has more Type 1 and 2 lobules where cancers start.

After mid pregnancy at 20 weeks, the fetus/placenta makes hPL, another hormone that starts maturing her breast tissue so that it can make milk. It is only after 32 weeks that she has made enough of the mature Type 4 lobules that are cancer resistant so that she lowers her risk of breast cancer.

Induced abortion before 32 weeks leaves the mother’s breast with more vulnerable tissue for cancer to start. It is also why any premature birth before 32 weeks, not just induced abortion, increases or doubles breast cancer risk.

By the end of her pregnancy, 85% of her breast tissue is cancer resistant. Each pregnancy thereafter decreases her risk a further 10%.

A woman can use this information to make an informed decision about her pregnancy. If she chooses to abort her pregnancy for whatever reason, she should start breast screening about 8-10 years later so that if she does develop a cancer, it can be found early and treated early for a better outcomes.

- Abortion: Women Not Allowed an Informed Decision, CAPoliticalNews.com, February 12, 2012.

本文仅代表作者本人观点，与本网立场无关。欢迎大家讨论学术问题，尊重他人，禁止人身攻击和发布一切违反国家现行法律法规的内容。

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About the author:

Zhang Xin is Trainer at chinadaily.com.cn. He has been with China Daily since 1988, when he graduated from Beijing Foreign Studies University. Write him at: zhangxin@chinadaily.com.cn, or raise a question for potential use in a future column.

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（作者 张欣 中国日报网英语点津 编辑：Helen）