Category: Free Speech

One Cause of Increasing Burnout of Physicians Is “the Politicization of Science”

(p. A25) Ten years of data from a nationwide survey of physicians confirm another trend that’s worsened through the pandemic: Burnout rates among doctors in the United States, which were already high a decade ago, have risen to alarming levels.

Results released this month and published in Mayo Clinic Proceedings, a peer-reviewed journal, show that 63 percent of physicians surveyed reported at least one symptom of burnout at the end of 2021 and the beginning of 2022, an increase from 44 percent in 2017 and 46 percent in 2011. Only 30 percent felt satisfied with their work-life balance, compared with 43 percent five years earlier.

“This is the biggest increase of emotional exhaustion that I’ve ever seen, anywhere in the literature,” said Bryan Sexton, the director of Duke University’s Center for Healthcare Safety and Quality, who was not involved in the survey efforts.

. . .

The increase in burnout is most likely a mix of new problems and exacerbated old ones, Dr. Shanafelt said. For instance, the high number of messages doctors received about patients’ electronic health records was closely linked to increased burnout before the pandemic. After the pandemic, the number of messages from patients coming into physicians’ In Baskets, a health care closed messaging system, increased by 157 percent.

And physicians pointed to the politicization of science, labor shortages and the vilification of health care workers as significant issues.

For the full story, see:

Oliver Whang. “New Survey Suggests An Alarming Increase In Physician Burnout.” The New York Times (Friday, September 30, 2022): A25.

(Note: ellipsis added.]

(Note: the online version of the story has the date Sept. 29, 2022, and has the title “Physician Burnout Has Reached Distressing Levels, New Research Finds.”)

Entrepreneur Andy Yen’s Technology Enables Russians to Elude Censors

(p. A1) After Moscow erected a digital barricade in March [2022], blocking access to independent news sites and social media platforms to hide information about its unfolding invasion of Ukraine, many Russians looked for a workaround. One reliable route they found came from a small Swiss company based nearly 2,000 miles away.

The company, Proton, provides free software that masks a person’s identity and location online. That gives a user in Russia access to the open web by making it appear that the person is logging in from the Netherlands, Japan or the United States. A couple of weeks after the internet blockade, about 850,000 people inside Russia used Proton each day, up from fewer than 25,000.

That is, until the end of March, when the Russian government found a way to block Proton, too.

Targeting Proton was the opening salvo of a continuing back-and-forth battle, pitting a team of about 25 engineers against a country embarking on one of the most aggressive censorship campaigns in recent memory.

Working from a Geneva office where the company keeps its name off the building directory, Proton has spent nine pressure-packed months repeatedly tweaking its technology to avoid Russian blocks, only to be countered again by government censors in Moscow. Some employees took (p. A9) Proton off their social media profiles out of concern that they would be targeted personally.

The high-stakes chess match mirrors what is playing out with growing frequency in countries facing coups, wars and authoritarian rule, where restricting the internet is a tool of repression. The blocks drive citizens to look for workarounds. Engineers at companies like Proton think up new ways for those people to secretly reach the open web. And governments, in turn, seek out new technical tricks to plug leaks.

. . .

Companies rarely discuss being targeted by an authoritarian government out of fear of escalating the conflict. But Andy Yen, Proton’s founder and chief executive, said that after a period of trying to keep its “head down,” Proton wanted to raise awareness about the increasing sophistication of governments, in Russia and elsewhere, to block citizens from reaching the open web and the need for technologists, companies and governments to push back.

. . .

“We’re gearing up for a long fight,” Mr. Yen said in an interview at the company’s office. “Everybody hopes this will have a happy ending, but it’s not guaranteed. We don’t see the light at the end of the tunnel, in fact, but you keep going because if we don’t do it, then maybe nobody else will.”

. . .

The battle took on a “Spy vs. Spy” dynamic in Proton’s headquarters. Mr. Yen said a network of people within the government, telecommunications firms and civil society groups had helped Proton operate in Russia, providing access to local networks and sharing intelligence about how the censorship system worked. But those contacts began to go dark as the Kremlin’s crackdown on dissent intensified.

. . .

Mr. Yen was interrupted during a staff meeting in mid-July with news that Russian censors had come up with an even more elaborate block. A corporate chart from the time shows use dropping off a cliff. Russian engineers had identified what is known as an authentication “handshake,” the vital moment when Proton’s VPN connection gets established before reaching the wider web. Blocking the link made Proton’s service essentially unusable.

“We had no idea what was happening and how they were doing it,” Mr. Cesarano said.

By August, after working around the clock for days to find a fix, Proton acknowledged defeat and pulled its app from Russia. The company has spent the months since then developing a new architecture that makes its VPN service harder to identify because it looks more like a regular website to censorship software scanning a country’s internet traffic. Proton has been successfully testing the system in Iran, where Proton has seen a sharp increase in VPN use during recent political demonstrations.

In Russia, Proton has reintroduced its apps using the new system. Mr. Yen acknowledged that it probably wasn’t a long-term fix. He has confidence in the new technology, but figures Russian engineers will eventually figure out a new way to push back, and the game will continue.

For the full story, see:

Adam Satariano and Paul Mozur. “The Cat-and-Mouse Battle for Russia’s Internet.” The New York Times (Wednesday, December 7, 2022): A1 & A9.

(Note: ellipses, and bracketed year, added.]

(Note: the online version of the story was updated Dec. 9, 2022, and has the title “Inside the Face-Off Between Russia and a Small Internet Access Firm.” )

Taiwanese Engineers Who Built Dictator Xi’s Computer Chips, Are Voting With Their Feet for Taiwan’s Democracy and Freedom

(p. B1) TAIPEI, Taiwan — The job offer from a Chinese semiconductor company was appealing. A higher salary. Work trips to explore new technologies.

No matter that it would be less prestigious for Kevin Li than his job in Taiwan at one of the world’s leading chip makers. Mr. Li eagerly moved to northeast China in 2018, taking part in a wave of corporate migration as the Chinese government moved aggressively to build up its semiconductor industry.

He went back to Taiwan after two years, as Covid-19 swept through China and global tensions intensified. Other highly skilled Taiwanese engineers are going home, too.

For many, the strict pandemic measures have been tiresome. Geopolitics has made the job even more fraught, with China increasingly vocal about staking its claim on Taiwan, a self-ruled democracy.

. . .

(p. B4) For now, Mr. Li is staying in Taiwan, working for an American chip company operating there and siding with the invigorated patriotic sentiment and the ethos of individual liberty.

“The advantage of working in Taiwan is that you don’t have to worry about officials shutting down the whole company because of one thought,” he said. “The atmosphere is very important. At least I can watch all kinds of programs criticizing the governments on both sides of the Taiwan Strait without worrying about being arrested.”

For the full story, see:

Jane Perlez, Amy Chang Chien and John Liu. “Taiwanese Who Built Up Chip Sector in China Are Fed Up and Going Home.” The New York Times (Tuesday, November 22, 2022): B1 & B4.

(Note: the online version of the story has the date Nov. 16, 2022, and has the title “Engineers From Taiwan Bolstered China’s Chip Industry. Now They’re Leaving.” The online version says that the title of the print version is “They Built Up China’s Chip Sector. Now, They’re Going Home to Taiwan” but the title of my national edition copy is “Taiwanese Who Built Up Chip Sector in China Are Fed Up and Going Home.”)

“It’s Not Clear What We Are and Aren’t Allowed to Say”

(p. B1) When Gov. Gavin Newsom signed into law a bill that would punish California doctors for spreading false information about Covid-19 vaccines and treatments, he pledged that it would apply only in the most “egregious instances” of misleading patients.

It may never have the chance.

Even before the law, the nation’s first of its kind, takes effect on Jan. 1 [2023], it faces two legal challenges seeking to declare it an unconstitutional infringement of free speech. The plaintiffs include doctors who have spoken out against government and expert recommendations during the pandemic, as well as legal organizations from both sides of the political spectrum.

“Our system opts toward a presumption that speech is protected,” said Hannah Kieschnick, a lawyer for the Northern California branch of the American Civil Liberties Union, which submitted a friend-of-the-court brief in favor of one of the challenges, filed last month in U.S. District Court for the Central District of California.

That lawsuit and another, filed this month in the Eastern District of California, have become an extension of the broader cultural battle over the Covid-19 pandemic, which continues to divide Americans along stark partisan lines.

. . .

(p. B5) The plaintiffs in California have sought injunctions to block the law even before it goes into effect, arguing that it was intended to silence dissenting views.

One of them, Dr. Tracy Hoeg, a physician and epidemiologist who works in Grass Valley, near Sacramento, has written peer-reviewed studies since the pandemic began that questioned some aspects of government policies adopted to halt the spread of Covid-19.

Those studies, on the efficacy of masks for schoolchildren and the side effects of vaccines on young men, exposed her to vehement criticism on social media, she said, partly because they fell outside the scientific consensus of the moment.

She noted that the medical understanding of the coronavirus continues to evolve, and that doctors should be open to following new evidence about treatment and prevention.

“It’s going to cause this very broad self-censorship and self-silencing from physicians with their patients because it’s not clear what we are and aren’t allowed to say,” said Dr. Hoeg, one of five doctors who filed a challenge in the Eastern District. “We have no way of knowing if some new information or some new studies that come out are accepted by the California Medical Board as consensus yet.”

. . .

Dr. Jeff Barke, a physician who has treated Covid patients at his office in Newport Beach in Southern California, said the law was an attempt by the state to impose a rigid orthodoxy on the profession that would rule out experimental or untested treatments.

Those include treatments with ivermectin and hydroxychloroquine that he said he had found to be effective at treating the coronavirus, despite studies suggesting otherwise. “Who determines what false information is?” he said.

. . .

“What comes next?” he said. “How I talk to patients about cancer? How I talk to patients about obesity or diabetes or asthma or any other illnesses? When they have a standard of care that they think is appropriate and they don’t want me going against their narrative, then they’ll say Barke’s spreading misinformation.”

For the full story, see:

Steven Lee Myers. “Law to Stem Medical Misinformation Is Facing a Free Speech Challenge.” The New York Times (Thursday, December 1, 2022): B1 & B5.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date Nov. 30, 2022, and has the title “Is Spreading Medical Misinformation a Doctor’s Free Speech Right?”)

Lancet Editorial Praised Chinese Communists’ Covid Policy of “Restricting Public Freedoms”

(p. A17) China’s zero-Covid policies have recently come under criticism from public-health leaders—including those at the World Health Organization—who once held them up as a model for the West.

“China’s success rests largely with a strong administrative system that it can mobilise in times of threat, combined with the ready agreement of the Chinese people to obey stringent public health procedures,” the Lancet editorialized on March 7, 2020. Western countries, it added, “must abandon their fears of the negative short-term public and economic consequences that may follow from restricting public freedoms as part of more assertive infection control measures.”

That hasn’t worn well. The negative social and economic consequences of lockdowns in the West—from learning losses and destroyed small businesses to alcoholism and drug abuse—weren’t “short-term.” Nor were China’s draconian zero-Covid policies, which three years later are only slowly being eased.

For the full commentary, see:

Allysia Finley. “LIFE SCIENCE; Western Scientists Cheered On China’s Covid Repression.” The Wall Street Journal (Monday, Dec. 12, 2022): A17.

(Note: the online version of the commentary has the date December 11, 2022, and has the same title as the print version.)

Persian King Cyrus Tolerated Diversity of Religion and Culture

(p. C12) After another year that has cried out for inspiring leadership, I grasped glimmers of optimism from Matt Waters’s “King of the World,” a biography of Persian king Cyrus the Great.

. . .

Today Cyrus is revered as a model of pragmatic, benevolent rulership.

. . .

. . . Cyrus imposed or forbade no religion, language, ethnicity, dress code or culture on his native Persians or the many other peoples he ruled. Would that this were the case for his descendants today.

For the full review, see:

Timothy Potts. “12 Months of Reading; Timothy Potts.” The Wall Street Journal (Saturday, Dec. 10, 2021): C12.

(Note: ellipses added.)

(Note: the online version of the review has the date December 8, 2022, and has the title “Who Read What in 2022: Thinkers and Tastemakers.”)

The book praised by Timothy Potts is:

Waters, Matt. King of the World: The Life of Cyrus the Great. New York: Oxford University Press, 2022.

Collins and Fauci Did Not Seek Open Debate on the Great Barrington Declaration

(p. A15) The Trump Twitter ban almost pales in comparison with the speech limitations routinely enforced on discussion of climate and Covid. Instead of “hate” or “violence,” the elastic pretext for speech restriction here is “settled science.”

The essence of science was once open debate. But that’s no longer true. In a now-infamous 2020 email, National Institutes of Health Director Francis Collins wrote Anthony Fauci that the Great Barrington Declaration, a dissent from Covid-lockdown policy, needed “a quick and devastating published take down,” which soon appeared in the press.

For the full commentary, see:

Henninger, Daniel. “WONDER LAND; They Want to Shut You Up.” The Wall Street Journal (Thursday, December 15, 2022): A15.

(Note: the online version of the commentary has the date December 14, 2022, and has the title “WONDER LAND; They Want to Shut You (and 303 Creative) Up.”)

Auto Experts Are Skeptical of EVs, but Are Afraid “So They Can’t Speak Out Loudly”

(p. A1) “People involved in the auto industry are largely a silent majority,” Mr. Toyoda said to reporters during a visit to Thailand. “That silent majority is wondering whether EVs are really OK to have as a single option. But they think it’s the trend so they can’t speak out loudly.”

. . .

(p. A6) The world’s biggest auto maker has said it sees hybrids, a technology it invented with the debut of the Toyota Prius in the 1990s, as an important option when EVs remain expensive and charging infrastructure is still being built out in many parts of the world. It is also developing zero-emission vehicles powered by hydrogen.

“Because the right answer is still unclear, we shouldn’t limit ourselves to just one option,” Mr. Toyoda said. Over the past few years, Mr. Toyoda said, he has tried to convey this point to industry stakeholders, including government officials—an effort he described as tiring at times.

Global car companies have made a sharp pivot to electric vehicles within the last few years, driven in part by the success of EV-only maker Tesla Inc.

. . .

At the same time, the legacy auto makers have a much broader base of customers, including many living in rural areas and developing economies with unreliable electricity supplies.

And their gas-engine businesses are still driving the bulk of profits needed to fund the costly shift to electric vehicles, which not only requires the development of new models but also construction of new facilities and battery plants.

The infrastructure to charge electric vehicles is meanwhile still lacking in the U.S. and many other parts of the world, making owning an EV still a challenge for many types of consumers.

. . .

Ryan Gremore, an Illinois-based dealer, who owns several brand franchises, said he gets a lot of customers inquiring about EVs, in part because of limited supplies.

That might give the impression of robust demand, but it is unclear how it will materialize when inventory levels at dealerships normalize, he added. “Is there interest in electric vehicles? Yes. Is it more than 10% to 15% of our customer base? No way,” Mr. Gremore said.

Mr. Toyoda’s long-held skepticism about a fully electric future has been shared by others in the Japanese car industry, as well.

Mazda Motor Corp. executives once cautioned that whether EVs were cleaner depends largely on where the electricity is produced. They also worried that EV batteries were too big and expensive to replace gas-powered models and better suited to the types of smaller vehicles that Americans didn’t want.

For the full story, see:

River Davis and Sean McLain. “Toyota Skeptical of Going All-EV.” The Wall Street Journal (Monday, Dec. 19, 2022 ): A1 & A6.

(Note: ellipses added.)

(Note: the online version of the story was updated Dec. 18, 2022, and has the title “Toyota Chief Says ‘Silent Majority’ Has Doubts About Pursuing Only EVs.”)

Across Communist China a Sheet of Blank White Paper “Is a Symbol of Tacit Defiance”

(p. A7) In Shanghai, a vigil grew into a street protest where many held blank sheets of white paper in a symbol of tacit defiance.

. . .

. . . in a country where the authorities have very little tolerance for open dissent, many communicated through subtler methods, and among the most prominent were the blank sheets of white paper used in Shanghai, Beijing and other cities.

. . .

Demonstrators used the white sheets to mourn those lost — white is a common funeral color in China — and to express an anger understood implicitly by millions who have suffered under pandemic restrictions.

The display of wordless papers “means ‘we are the voiceless, but we are also powerful,’” said Hazel Liu, a 29-year-old film producer who attended the vigil along the Liangma River in Beijing on Sunday [Nov. 27, 2022].

. . .

“People have a common message,” said Xiao Qiang, a researcher on internet freedom at the University of California, Berkeley. “They know what they want to express, and authorities know too, so people don’t need to say anything. If you hold a blank sheet, then everyone knows what you mean.”

Some protesters told The New York Times that the white papers took inspiration from a Soviet-era joke, in which a dissident accosted by the police for distributing leaflets in a public square reveals the fliers to be blank. When asked, the dissident replies that there is no need for words because “everyone knows.”

. . .

Some have pushed the protests in other creative directions. A statement that appeared to have been sent by one of China’s largest stationery companies circulated online, saying that the company would suspend sales of A4 paper to “safeguard national security and stability.” The company was forced to announce on its social media account that the message was fabricated and that all operations remained normal.

The muted defiance of the protests — often innocuous on the surface — has handed the police the nebulous task of deciding what crosses the line.

For the full story, see:

Chang Che and Amy Chang Chien. “With Sly Memes and Wordless Protests, Fed-Up Chinese Test the Authorities.” The New York Times (Tuesday, November 29, 2022): A7.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date Nov. 28, 2022, and has the title “Memes, Puns and Blank Sheets of Paper: China’s Creative Acts of Protest.”)

The McCarthy Era, and Right Now: Each a “Very Bad Time” for Free Speech

(p. A13) New Milford, Conn.

Old-fashioned liberalism doesn’t get much respect these days, and Nadine Strossen illustrates the point by pulling out a hat. “I have to show you this gift that somebody gave me, which is such a hoot,” she says, producing a red baseball cap that bears the slogan MAKE J.S. MILL GREAT AGAIN. “Which looks like a MAGA cap,” she adds, as if to help me narrate the scene.

As she dons it, I observe that if she walked around town in her bright-blue home state, angry onlookers would think it was a MAGA hat. “And,” she continues, “I can’t tell you how many educated friends of mine have said, ‘Who is J.S. Mill?’ So we really do have to make him great again.”

Ms. Strossen, 71, has made a career as a legal and scholarly defender of classical liberal ideals, most notably as president of the American Civil Liberties Union from 1991 through 2008. She brings up John Stuart Mill (1806-73), the British philosopher and parliamentarian, by way of citing his view, as she puts it, “that everything should be subject to re-examination,” including “our most cherished ideas.”

. . .

“For many decades now there’s been this asserted dichotomy or tension between equality rights and liberty,” Ms. Strossen says. “I continue to believe that they’re mutually reinforcing, that we can’t have meaningful liberty, in a meaningful sense, unless it’s equally available to everybody. . . . Every single one of us should have an equal right to choose how we express ourselves, how we communicate to somebody else, what we choose to listen to.”

She elaborates in her 2018 book, “Hate: Why We Should Resist It With Free Speech, Not Censorship,” and in our interview when we turn to higher education. Campus authorities frequently justify the suppression of “so-called hate speech”—Ms. Strossen is punctilious about including that dismissive qualifier—with what she calls the “false and dangerous equation between free expression and physical violence.”

“When people hear the term ‘hate speech,’ ” she says, “they usually envision the most heinous examples—a racial epithet; spitting in the face of Dr. Martin Luther King. But in fact, when you see what’s been attacked as so-called hate speech on campus, it’s opposing the idea of defund the police, opposing the idea of open borders.” Any questioning of transgender ideology or identity is cast as “denying the humanity of trans people, or transphobic.” Ms. Strossen hastens to add that “I completely support full and equal rights for trans people,” but she says critics are “raising concerns that I think deserve to be raised and deserve to be discussed.”

Ms. Strossen, herself a professor emerita at New York Law School, likens the situation on campuses to McCarthyism, “a climate of fear that leads to treating certain people with suspicion or, worse, ostracizing those people and those who try to defend them, and punishing them.”

. . .

On campus, she admits that things are worse than they’ve been at least since the McCarthy era—but she still tries to look on the bright side. “I am absolutely convinced that a future generation is going to look back on this time and say this is another very bad time,” she says.

For the full interview, see:

Tunku Varadarajan. “THE WEEKEND INTERVIEW; Make Freedom of Speech Liberal Again.” The Wall Street Journal (Saturday, Aug. 6, 2022): A13.

(Note: ellipses between paragraphs, added; ellipsis internal to paragraph, in original.)

(Note: the online version of the interview has the date August 5, 2022, and has the same title as the print version.)

The Strossen book mentioned in the interview is:

Strossen, Nadine. Hate: Why We Should Resist It with Free Speech, Not Censorship. New York: Oxford University Press, 2020.

If Apple and Google Ban Twitter from Their Phone App Stores, Musk Will Start Making Phones

Elon Musk said he would make his own smartphone if Google and Apple were to ban Twitter from their app stores.

Musk said in a tweet responding to conservative podcaster Liz Wheeler that he hopes the situation does not come to that but that he will make that decision if necessary.

“I certainly hope it does not come to that, but, yes, if there is no other choice, I will make an alternative phone,” he said.

Wheeler first proposed the idea, saying that half of the country would “happily ditch the biased, snooping iPhone and Android.”

“The man builds rockets to Mars, a silly little smartphone should be easy, right?” she tweeted.

For the full story, see:

JARED GANS. “Elon Musk says he would make his own smartphone if app stores ban Twitter.” THE HILL (Saturday, Nov. 26, 2022). URL: https://thehill.com/policy/technology/3750849-elon-musk-says-he-would-make-his-own-smart-phone-if-app-stores-ban-twitter/.