Wednesday, 31 July 2013

Quality of life, quality of death

ST shared a link via iOS:
26 July 2013
The Drawn-Out Indignities of The American Way of Death

A disturbing and surprising read for me. Under Australian law, people have to right to decline treatments offered, but they do not have the right to demand treatments that are not appropriate. Conversely, doctors are not obliged to offer treatments that are considered futile. Regarding limitations of treatment, it is the responsibility of doctors to first decide what interventions will be offered in the event of deterioration. People can then decide that they want less than what is offered, but they do not have to right to demand beyond what is appropriate.

Despite the finite resources of the health system, the main role of treatment limitations is not to save money, but to not harm the patient; primum non nocere. Although death has become a more taboo topic since the days of Queen Victoria and Emily Dickinson, it remains an inevitable reality. When it is time, people should die peacefully, with dignity, and without unnecessary and prolonged suffering. Inappropriate resuscitation attempts are not only futile, but rob people and their loved ones of this "quality of death."

Therefore, if resuscitation is not medically appropriate, I do not ask people if they would want it, but tell them that it will not be attempted and why this is in their best interests. In this situation, the choice is not theirs, for while they have the right to decline what is offered, they do not have the medical training and experience (other than starkly unrealistic television portrayals of resuscitation effectiveness) to decide what treatments are appropriate to offer. It is unfair to burden people with decisions that should not be theirs and subject them to the risk of misplaced guilt, needlessly wandering in silence for decades after whether they "gave up on their loved one by pulling out too early."

Friday, 19 July 2013

Shadows of Pigovia

News.com.au
16 July 2013
Carbon tax to go by July 2014.

From a global perspective, carbon taxation is economically justified as greenhouse emissions constitute negative externalities. The market prices of goods and services that create such externalities do not reflect their true societal cost, resulting in their overutilisation and ensuing deadweight loss. To prevent a tragedy of the commons, Pigovian taxation is needed to correct for this market failure.

Compared to a simple carbon tax, an emissions trading scheme offers several advantages. A mandated carbon quantity rather than price allows for better control towards emission targets. The ability to trade emission permits allows reduction efforts to be redistributed to where their marginal cost is lowest, resulting in improved efficiency. However, depending on the execution, an emissions trading scheme is also more vulnerable to loopholes that undermine reduction efforts and even potentially lead to worsening of greenhouse emissions.

The first issue concerns the primary market for emission permits. Under the present implementation of the Kyoto Protocol, the predominant primary market is free allocation rather than auction. This practice carries the same disdvantages that lead to the failure of Marxism, for the practices of command economies cannot feasibly approach the allocative efficiency of free markets. Inevitable mismatches in allocations have resulted in windfall profits to some carbon emitters. This constitutes a subsidy for carbon emitters, an "anti-Pigovian" measure that exacerbates pre-existing negative externalities, leading to potential increased emissions.

The second issue concerns the Clean Development Mechanism of the Kyoto Protocol, where parties can offset their permitted carbon emissions by investing in emission reduction projects. This offers added flexibility and also corrects for positive externalities but carries numerous flaws:
  • It is difficult to determine the suitable number of offset credits to award. For example, as carbon sinks, forests vary unpredictably in carbon capacity and are insecure as long-term storage. Meanwhile, forest planting itself releases emissions, and the presence of forests in some cases can actually worsen global warming due to increased solar absorption¹.
  • It is difficult to determine the additionality of projects. Awarding offset credits for measures that would have been economically indicated anyway without the Kyoto Protocol consitutes a second anti-Pigovian subsidy for carbon emitters and leads to oversupply of carbon credits.
  • Perverse incentives arise. Awarding offset credits for removing potent greenhouse emissions incentivises companies to produce more of those emissions in order to be paid to remove them. For example, the use of credits derived from fluoroform and nitrous oxide removal projects are now banned in the European Union and New Zealand due to systematic abuse. 
Even with an auction-only primary market and the removal of carbon offset mechanisms, there remains a third issue concerning the inherent price volatility of an emissions trading scheme. This invites secondary market agiotage, raising the carbon price and resulting in "inefficient taxation", where portion of revenue is paid to private speculators instead of the state. Furthermore, it is conceivable that the largest carbon emitters will hold an advantage on the secondary market due to information asymmetry. This effectively constitutes a third anti-Pigovian subsidy for carbon emitters.

An Australian transition to an emissions trading scheme offers potential advantages at the cost of potential disadvantages that may attentuate and even reverse any gains. The Opposition's Direct Action Plan is no palatable alternative to a carbon tax due to the inherent weakness in a command rather than market economy approach. An Australian emissions trading scheme should have an auction-only primary market. While I am not against limited use of temporary protectionism for easing economic transitions, I do not believe this is indicated here as we are transitioning from an existing fixed-price carbon tax rather than free carbon. A carbon offset mechanism should be avoided, as this has the largest potential for unfruitful complexity and counter-productive loopholes. The European Union trading scheme thus far has attracted criticism for being ineffective² and Australia must be wary of inheriting its failures.

References:

Tuesday, 16 July 2013

Price of progress

The Age
11 July 2013
The record of deaths and diseases over the past 60 years shows nuclear power is safer than every other source of energy.

While I must admit a fondness for the counter-intuitive, after examining the figures¹ quoted in this article, I feel that the calculations contain a number of flaws. The 0.04 deaths per TWh for nuclear power was arrived by presuming 4000 Chernobyl-related deaths over 112000 TWh for the total extrapolated nuclear power generated between the Chernobyl disaster and 25 years into the future, over which time those deaths are expected to occur. Three problems immediately come to mind: 
  • The 4000 Chernobyl-related deaths is a lower estimate, calculated from the effects on only the worst affected areas. Other studies² which consider a larger geographical area of contamination estimate up to 60000 excess deaths.
  • The divisor of 112000 TWh is blatantly invalid as it assumes that there will be no further nuclear accidents (such as Fukushima) between the index year of 2005 and 2030. Instead, the deaths should be calculated at the time of their causation. The argument that these deaths are chronic and not presently attributable should not apply because the author has also used similar chronic deaths associated with air pollution to arrive at his figure for coal-related deaths.
  • The author has only considered nuclear power deaths associated with the Chernobyl disaster itself, ignoring other deaths related to nuclear power, such as the Kyshtym disaster of 1957. Meanwhile, deaths for other power sources have been derived from accidents associated with mining and facility maintenance, whereas these figures have not been included in the nuclear power calculation.
After accounting for the issues above, one may arrive at a figure of over 1.4 deaths per TWh for nuclear power. While still a small figure compared to fossil fuels, the author's contention that nuclear power is significantly safer than renewable energy is no longer tenable.