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Free Fernando Vina (part two)

I'm still mystified by certain aspects of Major League Baseball's drug policy.

Consider the following:

An aging pitcher is suffering from a variety of persistent injuries. They are healing slowly. He is depressed and lethargic, and anxious about his career. He goes to see his doctor. The doctor finds that the patient's testosterone count is low. He prescribes the pitcher a small dose of testosterone, as part of  his rehab. The patient is desperate, and the doctor agrees to experiment with testosterone, and see if it speeds recovery.

Questions:

1. Has the pitcher violated MLB's drug policy? As far as I can tell, yes. Testosterone is on baseball's list of banned substances.

2. Has the patient violated the law? Of course not. Testosterone is an FDA approved medication.

3. Has the doctor done anything wrong? Not at all. The doctor could also have prescribed human growth hormone, if he wanted to.  Even though HGH is not approved for injury recovery, a physician is free to prescrbe virtually any drug he/she wants to, in an off-label manner.

4. Should the doctor and the athlete feel guilty about what they've done? I don't see why. The foundation of our medical system is that physicans have broad leeway to act in the best interests of their patients, and if the physician thinks that testosterone might help the athlete he's entirely within his rights to prescribe it. The pitcher is also entitled to take every step he can to regain his health. Surely it is wrong--if not unconstitutional-- for an employer to impede an employee from receiving the best medical attention.

5. Will Major League Baseball ever find out about the pitcher's testosterone use? Not unless the pitcher tells someone. The transaction between a patient and a doctor is, of course, covered by patient confidentiality laws.

6. Does this mean that lots of professional athletes may already be using substances like testosterone--and we have no way of finding out? Of course!

7. So why did Vina and Pettitte and Bennett get in trouble? Because, presumably, they obtained their HGH without an prescription--which is illegal.

8. So wait. The league's drug policy is an attempt to prevent the use of drugs without a prescription? No. Its supposed to prevent the use of a broad class of drugs. But since the league's policies  clearly can't govern drugs prescribed legally by a physican--particuarly if they are undetectable-- it has the effect of only preventing the use of drugs obtained illegally.

9. I'm confused. Aren't there already laws in place in America preventing the use of drugs without a prescription? Yes. (And I'm confused too.)

Will someone please tell me if I've got this right?

Free Fernando Vina!

From an Associated Press press article today, on ex-major leaguer player Fernando Vina admitting to using Human Growth Hormone:

Slow to recover from knee and hamstring injuries, Vina played only 61 games for the Cardinals in 2003. He said he was under pressure from the team and himself to get back on the field, so he tried HGH.

''I tried everything rehabbing,'' Vina said. ''I came to a point that I was desperate.''

New York Yankees pitcher Andy Pettitte, also cited in the report, recently acknowledged using HGH for a similar reason -- to try to recover from a sore elbow in 2002.

Backup catcher Gary Bennett, also named by Mitchell, said he took HGH in 2003 because of a knee injury. He signed with the Los Angeles Dodgers on Monday.

At 5-foot-9, 170 pounds, Vina said he wasn't trying to bulk up -- his job was to slap the ball around and use his quickness to get on base. He said he turned to HGH hoping to get healthy.

''Was it right? No. Obviously, it was wrong,'' Vina said. ''I'm embarrassed by it.''

Can someone tell me why Vina said "obviously, it was wrong"?

Let's assume, for a moment, that what Vina said was true--that he only took HGH because he was trying to recover from an injury.  Let's assume the same of Pettitte and Bennett. I think we can also agree that there is reasonable evidence that Human Growth Hormone speeds recovery.

So what, exactly, is wrong with an athlete--someone who makes a living with their body--taking medication to speed their recovery from injury?  Is it wrong to take ibruprofen? Is it wrong to ice a sore elbow? For that matter, is it ethical or even legal for Major League Baseball--or indeed any employee or governing body--to deny an employee access to a potentially beneficial medical treatment?

The closest analogy I can think of here is to medical marijuana, which is another case where it seems difficult for some people in positions of power to understand that a drug can be used for more than one purpose.

Race and IQ, con't.

More thoughts on Eric Turkheimer's research:

The more I think about it, the more convinced I am Turkheimer's work is one of the keys to unraveling the Race-IQ debate. His argument goes something like this:

Right now, there are two conflicting pieces of evidence, each of which is seized upon by each side in the debate. On the one hand, there are twin studies. You look at twins, raised in very different adoptive families, and you find that their IQs are very similar. That suggests IQ is largely heritable, and that environment plays only a modest role.

On the other hand, there are studies showing that if a child of a very poor family, adopted at birth into a wealthy family, will have a much higher IQ than his or her siblings, or his or her parents, who remain in poverty. 

This is, obviously, not a trivial disagreement. Someone like Charles Murray, who takes the former position, uses it as explanation for why he think social programs--like Head Start--are a waste of time and money. It is also why he thinks that the gap that presently exists between white and black average IQ scores will likely persist, regardless of what kind of steps we take as a society.  Liberals, meanwhile, use the latter evidence to justify the idea of an aggressive social policy.

So who's right? Turkkeimer would say, both sides are. 

He used a very large data set--the National Collaborative Perinatal Project--and found that the relationship between socio-economic status and IQ was non-linear. Children moving from poverty to the middle class see their IQ's jump: IQ at that end of the socio-economic scale is highly sensitive to environmental improvements. But the kinds of twins studies usually relied upon by IQ  fundamentalists and that yield such high genetic effects, are much more likely to involve comparisons among middle and upper middle class environments--and that end of the scale, Turkheimer's data suggests, environment doesn't play a big role. 

In other words, the lawyer who plays Mozart in the crib for his daughter, in order to raise her IQ, is wasting his time.  But dramatically increasing the educational resources available to inner city kids makes a  lot of sense.

This, I think, helps to clarify a lot of what drives so many of us crazy about Charles Murray and his ilk. We're not disputing the importance of IQ. And we're not disputing that genes play a huge role in determining IQ. We're just saying that it's hopelessly naive to assume that the same rules apply to suburban, middle-class whites as apply to, say, urban, inner-city black families.

Correction

To my chagrin, I made an error in my New Yorker piece "None of the Above." In the "Bell Curve," Charles Murray and Richard Hernstein did not advocate a "high-tech Indian reservation" for low-IQ groups. Rather, they warned that if current welfare policies continued, we would end up having to build high-tech reservations for those with low IQs--which is a very different argument, obviously (although not, if you think about it, any less ridiculous). I regret the error. The New Yorker will be running a correction.

Race and IQ

My contribution to the (endless) Race-IQ debate is out in this week's New Yorker. You can read it here. In the meantime, the psychologist Richard Nisbett has also published a rejoinder to the James Watson-Will Saletan foolishness in Sunday's New York Times. It is--characteristically--very good, and includes this:

The hereditarians begin with the assertion that 60 percent to 80 percent of variation in I.Q. is genetically determined. However, most estimates of heritability have been based almost exclusively on studies of middle-class groups. For the poor, a group that includes a substantial proportion of minorities, heritability of I.Q. is very low, in the range of 10 percent to 20 percent, according to recent research by Eric Turkheimer at the University of Virginia. This means that for the poor, improvements in environment have great potential to bring about increases in I.Q.

I confess that I haven't read Turkheimer's research. But take a look for yourself at the paper Nisbett is refering to here.

It's very persuasive. And it would be interesting to see what, if anything, die-hard hereditarians like Charles Murray have to say in response.