Higher Target Hemoglobin Levels Linked With Cardiovascular Events

http://www.medscape.com/viewarticle/548067

Yael Waknine
Medscape Medical News 2006. © 2006 Medscape

November 20, 2006 — The US Food and Drug Administration (FDA) has warned healthcare professionals regarding the significantly increased risk for serious and life-threatening cardiovascular (CV) complications associated with normalization of hemoglobin levels in patients receiving erythropoiesis-stimulating agents (ESAs), according to an alert sent Friday from MedWatch, the FDA's safety information and adverse event reporting program. The normal hemoglobin count is 12 to 16 g/dL for women and 14 to 18 g/dL for men; the recommended target level is 11.3 g/dL and should not exceed 12 g/dL for patients receiving epoetin alfa (Epogen/Procrit) or darbepoetin alfa (Aranesp, both made by Amgen, Inc).

The warning was based primarily on data from the Correction of Hemoglobin and Outcomes in Renal Insufficiency (CHOIR) study that was published on November 16 in the New England Journal of Medicine. For the study, 1432 chronic kidney disease (CKD) patients with anemia were randomized to receive epoetin alfa to target hemoglobin concentrations of either 13.5 g/dL or 11.3 g/dL.

Results showed that the rate of CV events was significantly increased in the higher-target group, as evaluated using a composite vascular end point (hazard ratio = 1.3; 95% confidence interval, 1.03 - 1.74; P = .03). End point components consisted of all-cause mortality (7.3% vs 5.0%; P = .07), congestive heart failure hospitalization (9.0% vs 6.6%; P = .07), nonfatal myocardial infarction (2.5% vs 2.8%), or nonfatal stroke (1.7% for both target groups).

The FDA notes that these findings were supported by data from the Risk Reduction by Early Anemia Treatment with Epoetin Beta (CREATE) study, which showed a similar trend in 603 patients receiving epoetin beta. Epoetin beta has not been approved by the FDA.

Healthcare professionals are advised to adhere to a target hemoglobin range of 10 to 12 g/dL in ESA-treated patients. Hemoglobin levels should be measured twice a week for 2 to 6 weeks after dose adjustments to ensure stabilization.In addition, ESA dose should be reduced if the rate of hemoglobin increase exceeds 1 g/dL in any 2-week period. Although CHOIR study analyses revealed no correlation between the rate of hemoglobin rise and CV events, the FDA notes that the related risk for seizures remains a concern.

To ensure hemoglobin stabilization after initial therapy, chronic renal failure patients should be monitored twice weekly; zidovudine-treated HIV patients and those with cancer should be monitored once weekly. Close monitoring and maintenance of blood pressure control is advised for patients with a history of CV disease or hypertension.

Epoetin alfa and darbepoetin alfa injection are indicated for the treatment of anemia associated with chronic renal failure and for chemotherapy-related anemia in cancer patients. Epoetin alfa is also indicated for the treatment of anemia related to zidovudine therapy in HIV patients and for the reduction of allogenic blood transfusion in anemic surgical patients.

Adverse events potentially related to treatment with epoetin alfa and darbepoetin alfa should be reported to the FDA's MedWatch reporting program by phone at 1-800-FDA-1088, by fax at 1-800-FDA-0178, online at http://www.fda.gov/medwatch, or by mail to 5600 Fishers Lane, Rockville, MD 20852-9787.

Dawkins: Nazi Eugenics "May Not Be Bad"?

http://proexistence.blogspot.com/

Thursday, November 23, 2006

By Rick Pearcey -- The headline at LifeSite is stunning: "Anti-Religious Extremist Dawkins Advocates Eugenics." Moreover, says the kicker, Dawkins "says Nazi regime’s genocidal project 'may not be bad'.

"The report begins: "A leading international anti-religion crusader and supporter of Darwinian theory, Dr. Richard Dawkins, has said that the pseudo-science of eugenics that drove the Nazi regime’s genocidal project 'may not be bad.'

"Since the end of the second world war," LifeSite reports, "the name of eugenics, the social philosophy that the human species or particular races ought to be improved by selective breeding or other forms of genetic manipulation, is one that conjures instant images of the Nazi death camps and 'racial hygiene' programs.

"Now comes Dawkins: "In a letter to the editor of Scotland’s Sunday Herald, Dawkins argues that the time has come to lay this spectre to rest. Dawkins writes that though no one wants to be seen to be in agreement with Hitler on any particular, 'if you can breed cattle for milk yield, horses for running speed, and dogs for herding skill, why on Earth should it be impossible to breed humans for mathematical, musical or athletic ability?'

”People are outraged, as one might expect. But it's hard to disagree with Dawkins, if one accepts Darwinian presuppositions.

Evolutionary theory asserts an unbroken line of continuity between life and nonlife, from the empty void of nothingness, to the impersonal particle, to the unconscious amoeba, to the cute little monkey, to the magnificent artist decorating the Sistine Chapel.

In such a framework, there seems no logical or moral barrier to the breeding of human beings for particular kinds of purposes, whether that breeding is imposed by a secular state or promoted by the free market. If the Darwinian view is correct, then what evolutionists regard as our true creator -- the cosmos -- has produced a form of existence (humanity) which over time has come to possess the power to manipulate human reproduction.

That same cosmos, however, is silent regarding the morality of reproductive manipulation and control. The impersonal universe is indifferent to such concerns. In this view, there is no Heaven above, no Hell below, and the particles care not about peace on Earth.

Let us consider where this line of thinking would lead us, if we are to take it seriously as a reality-oriented truth-claim about life in this world. If it is agreeable in principal to breed humans for "mathematical, musical, or athletic ability," then what possible ethical objection could there be to breeding blacks for speed, Jews for herding, whites for swimming, and women for yielding milk?

The rocks do not cry when a baby dies. Electrons do not pause at half-time for a moment of silence. Venus does not remember where it was when JFK died.

If that’s all there is to existence -- variations on the theme of cold rocks and impervious particles –- then, in the impersonal Darwinian universe, what really is the spectre? "Hitler" isn't the spectre. We are, that is, humanity, those who wonder and question.

Yes, conceptually speaking, Hitler is at one with the ethically insensate cosmos, for he believed in the rule of power in the struggle for survival of the strong over the weak.

No, subjecting human reproduction to the eugenic machine in the struggle for survival isn’t the problem: We are. We resist. We question and slow things down. We ghosts of humanity are cogs in the machine.

So the question is: Who are we to stand in the way of progress? The Darwinists want to know. Who are we to question? The Darwinists want to know. And who are we to think we’re special, not exhaustively identified with nature? The secular priests know what to do: Let doubters be cast out as alienated misfits unreconciled to science.

But we revolt. We shake our fists against the indifferent, empty sky. And that is good. We accept the aspirations of meaning and worth and goodness that animate our lives. Our heartache in the face of worldviews too small tells us the sky may not be as empty as some presuppositions require.

There are voices other than those typified by Mr. Dawkins, who is driven to excess by the impress of his view of life. They are rebellious voices who ask questions first and trust later.

I have heard there are people abroad in the land, wild people. They think the science and the evidence and their humanity point in a direction shockingly different from Darwin. There is talk about a strange worldview founded upon a Creator who endows every single human being, every race, every color, with certain inalienable rights. Add a little water and sunlight, it is said, plus determination, and this worldview yields an amazing bounty of human freedom, creativity, beauty, and love.

Hope abounds. Sadly, some may not be able to endure the night without Darwin to console their emptiness. On the other hand, the shadowy world of eugenics and death camps seems less likely to last without Darwin's hand to block the light and justify the darkness.

Orthodox atheists may not like it, but the shouts of the evolutionary priesthood may signal the demise of a great secular dream. Besides, the alternative looks pretty good: There's something appealing about holding science up without casting humanity down.

Note: The entire LifeSite story is here.
Rick Pearcey is editor and publisher of The Pearcey Report.

Pluralism will prevail

http://www.iht.com/articles/2006/09/13/opinion/edweiss.php#

Stanley A. Weiss International Herald Tribune

Published: September 13, 2006

JAKARTA You could be forgiven for thinking that Indonesia, long admired as a beacon of Muslim moderation, is descending into an Islamic theocracy.

Christian churches are torched. Western resorts, hotels and embassies are bombed. Abu Bakar Bashir, the radical cleric imprisoned for inspiring the Bali bombings of 2002, receives a hero's welcome home from fellow jihadists.

Across the country, more than two dozen cities and districts have imposed variations of Shariah, Islamic law, requiring women to wear headscarves and banning alcohol, gambling and adultery.

But a visit with Dr. Zulkieflimansyah (who, like many Indonesians, uses one name and is more commonly known as Zul) reveals the more complex face of political Islam here.

As vice chairman of the Justice and Prosperity Party, a rapidly- growing Islamic party with two cabinet ministers, Zul speaks of the need for an "Islamic moral code" in a country that is more than 80 percent Muslim.

But the 34-year-old British-trained economist equivocates when I ask if his party will push for Shariah: "This is difficult. If we say no, we will be rejected by the Muslims. If we say yes, there are too many definitions of Shariah."

So Zul, now a gubernatorial candidate whose running mate is a well-known actress-turned-politician, speaks of fighting corruption and poverty and creating jobs and investment. "All this can be considered Shariah," he says. "We are not trying to create a new society like the Arabs. Pluralism is a fact of life, and radical Islam is our enemy."

Zul's deft balancing act mirrors that of Indonesia - the country with the world's largest Muslim population but which, as a state, is officially neither secular nor Islamic.

After proclaiming independence in 1945, attempts to forge an Islamic state were thwarted when nationalists removed from the new constitution the famous "seven words" - "with obligation for Muslims to practice Shariah."

Instead, the official ideology of Pancasila - "five pillars": belief in one God, humanitarianism, national unity, democracy and social justice - was a quintessentially Indonesian compromise, acknowledging the role of religion in public life while guaranteeing the freedom of six state-recognized faiths: Islam, Protestantism, Catholicism, Hinduism, Buddhism and Confucianism.

Ever since, attempts to create an Islamic state or impose Shariah nationally, whether by bullet or ballot, have been soundly defeated. As recently as 2002, parliament overwhelmingly rejected amending the constitution to allow for Shariah.

Defeated nationally, Islamists have gone local, empowered by a decentralization movement allowing greater regional autonomy - most notably in conservative Aceh, where canings of Shariah offenders have drawn international condemnation.

But "Aceh does not represent Indonesia," as an Australian diplomat told me. In a nation of 240 million people, Shariah in a few cities and districts is an aberration. In fact, there already are signs of a backlash against Shariah among Indonesian Muslims, who largely espouse a less rigid form of Islam that blends Hinduism, Buddhism and Javanese mysticism.

"Democracy can be noisy," Vice President Jusuf Kalla tells me, but in Indonesia "there are far more moderates than radicals."

Indeed, a major poll last month showed that the vast majority of Indonesians reject Shariah and still embrace Pancasila. But in treating the symptoms of extremism, Jakarta must not ignore underlying causes.

With 40 million chronically unemployed and perhaps 100 million living in poverty, "we are running out of time," says Defense Minister Juwono Sudarsono, who oversees a military that considers itself a guardian of constitutional pluralism.

President Susilo Bambang Yudhoyono, accused of being indecisive on the economic front, now appears to understand the urgency. Jakarta is alive with rumors that he plans a dramatic "October Surprise," reshuffling his cabinet, with an eye toward a bold New Deal-style program to create jobs and combat poverty.

The murderous acts and militant agenda of a radical few here are making headlines. But historically, culturally, religiously and politically, Indonesians give hope that the center will hold - that they will succeed in what Sudarsono calls "the big challenge of daring young Muslims not to die for Islam, but to live for Islam."

Stanley A. Weiss is founder and chairman of Business Executives for National Security, a nonpartisan organization based in Washington.

HIV Epidemic Grows to 39.5 Million Infected

http://health.aol.com/news/story/_a/hiv-epidemic-grows-to-395-million/n20061121053609990008?cid=474

By ELIANE ENGELER

AP

GENEVA (Nov. 21) - The global HIV epidemic is growing, leaving an estimated 39.5 million people worldwide infected with the deadly virus, the United Nations said Tuesday.

AIDS has claimed 2.9 million lives this year and another 4.3 million people became infected with HIV, according to the U.N.'s AIDS epidemic update report, published on Tuesday. Spread of the disease was most noticeable in East Asia, Eastern Europe and Central Asia.

AIDS has killed more than 25 million people since the first case was reported in 1981, making it one of the most destructive illnesses in history.

"In a short quarter of a century AIDS has drastically changed our world," U.N. Secretary-General Kofi Annan said at a staff meeting Monday in Geneva. "AIDS, tuberculosis and malaria make up the deadliest triad the world has known."

But he said improvement in treatment, more resources and higher political commitment over the past 10 years gave rise to optimism.

The joint report by UNAIDS and the World Health Organization acknowledged that access to HIV/AIDS treatment has made a great leap forward in recent years, enabling many infected people to live longer. But it said much remained to be done, especially in prevention.

Sub-Saharan Africa - with 63 percent or 24.7 million of the world's infected people - bears the highest burden, but in East Asia, Eastern Europe and Central Asia there are 21 percent more people living with HIV than two years ago.

The virus spread fastest in Eastern Europe and Central Asia, with a nearly 70 percent increase in new infections over the past two years. In South and Southeast Asia, the number of new infections has grown by 15 percent since 2004, while it rose by 12 percent in North Africa and the Middle East. In Latin America, the Caribbean and North America it remained roughly stable.

All regions of the world have had an increase in the number of people living with the deadly virus over the past two years, the report said. In some countries this was due to better access to medicine keeping people alive longer.

Never before have so many women been infected with HIV. There are 17.7 million women worldwide carrying the virus, an increase of more than 1 million compared with two years earlier. The proportion of women among the infected is particularly striking in sub-Saharan Africa where they account for 59 percent of the people with HIV/AIDS.

The report doesn't break down the estimates country by country, but it said the United States - for which figures were available for 2005 only - had 1.2 million people living with HIV last year. The U.S. therefore ranks among the top 10 countries in terms of infected people.

Unprotected sex in prostitution and between men, as well as unsafe drug injecting represent the highest risks for HIV infection and the main reasons for the spread of the disease in Asia, Eastern Europe and Latin America, it said.

After sub-Saharan Africa, Asia is the second most infected region. Almost 8 million of the world's people with HIV/AIDS live in South and South East Asia. The report said there is increasing evidence for HIV outbreaks among men who have sex with each other in Cambodia, China, India, Nepal, Pakistan, Vietnam and Thailand, but it said few of these countries' AIDS programs really address the problem of sex between males.

In North America, an estimated 1.4 million people are infected, which represents a steady increase over the past few years mainly due to the life-prolonging impact of antiretrovirals.

In the United States, people from racial and ethnic minorities are more affected by the epidemic, with half of the AIDS diagnoses between 2001 and 2004 among African Americans and 20 percent among Hispanics.

But infected people in the U.S. have been benefiting from more effective treatment over the past few years, leading to a 21-percent increase of infected people surviving two years or longer since the early 1990s.

Copyright 2006 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. All active hyperlinks have been inserted by AOL.

11/21/06 05:32 EST

Nine Ways to Manage Money Effectively

http://articles.news.aol.com/business/_a/nine-ways-to-manage-money-effectively/20061120130309990004?cid=1712

By SHEFALI ANAND, The Wall Street Journal

(Nov. 20) - You get the idea.

As a columnist, my goal isn't to report the news or to offer up an ever-changing list of experts' investment recommendations. Rather, there are some key financial insights that, I believe, should guide everyone's investing, and I pound away at them week after week.

I have been talking about some of these ideas for years, while others have only recently captured my imagination. Want to manage your money better? Here, I would argue, are nine of the most important financial ideas.

1) Just Say No

To save and invest successfully, nothing is more critical than self-discipline.

That means settling on a mix of stock, bond and money-market funds and then sticking with that mix, no matter how unnerving you find the market's daily turmoil and no matter how tempted you are to buy the latest hot stock.

More important, you also need the ability to delay gratification, so you save a healthy sum on a regular basis.

2) Get Off the Treadmill

You can't spend your way to happiness. But lots of folks try, setting themselves up for a lifetime of hefty credit-card bills and emotional disappointment.

You know the cycle: You see something in the store, you decide you just have to have it, you pony up the bucks and, a few weeks or months later, the purchase is all but forgotten -- and you're hankering after something else.

Academics refer to this as the hedonic treadmill. The lesson? If you want happiness, you won't find it at the shopping mall.

3) We Are the Market

Despite all the talk of beating the market, there's a devastating piece of logic that stands stubbornly in our path.

We can't all beat the market, because collectively we are the market. If somebody beats the market, somebody else must lag behind.

In fact, once investment costs are figured in, there are very few winners and most of us trail the market averages.

4) Their Gain, Your Pain

All this should be a reminder that, like it or not, you have two investment partners: Wall Street and the taxman. The three of you divvy up your investment spoils.

Want to keep more for yourself and pay less to the Street and to the taxman? Your best bet is to clamp down on investment costs and make the most of tax-sheltered retirement accounts.

5) Help Wanted

A decade ago, I would have argued that most investors were capable of investing on their own. I no longer believe that's the case.

It seems most folks don't have the time, interest and emotional fortitude to invest successfully on their own.

But unfortunately, you may not fare much better if you hire a broker or financial planner. Many advisers charge too much and have had scant formal financial education, so you really need to pick your adviser with extraordinary care.

6) Don't Be Left Behind

When experts argue the case for diversification, they will point out that buying a wide variety of investments can lower risk, because some of these investments will post gains when others are suffering.

The problem: Whenever we get a major financial crisis, diversification -- especially global stock-market diversification -- often proves pretty much useless, because everything plummets at the same time.

Yet I think this misses a key point. Even if, say, U.S. and foreign stocks tend to rise and fall in tandem, there are often startling differences in their annual return. Those who own just one market can end up suffering long periods of lackluster performance.

Moreover, diversification isn't just about tempering short-term swings in your portfolio's value.

You also want to limit the damage done by financial calamities, whether it's political upheaval that shutters a country's financial markets or the sort of devastating market collapse we saw in Japan in the 1990s.

7) Family Matters

Your children are your legacy. They will inherit your money and they will likely adopt your financial values.

Your family is also your greatest asset and your greatest liability. If your children or your parents get into financial trouble, you would likely help out -- and they would likely help you, should you get into difficulty.

It's worth keeping all this in mind. Talk to your elderly parents about their finances. Endeavor to teach your kids about money.

Think about how you manage your own money -- and what the consequences would be for your family, should something go badly wrong.

8) Invest for the Long Term

If you die young, it could be financially devastating for your spouse and children. But don't ignore the other risk: What if you live far longer than you ever imagined?

Many retirees are so concerned about dying young that they rush to claim Social Security early and they refuse to buy lifetime-income annuities. And this is indeed the right strategy if you're convinced that you and your spouse have a short life expectancy, and you want to die a little richer.

But what if you take Social Security early, don't buy the annuity and then live a surprisingly long time? Instead of dying young and rich, you could be very much alive -- and pinching pennies.

9) Last Resort

On days when the financial markets are open, I check the yield on inflation-indexed Treasury bonds every few hours.

As of Friday, for instance, 10-year inflation-indexed Treasurys were yielding 2.3 percentage points above inflation.

To me, inflation-indexed Treasurys are the investment against which all others should be measured. If I buy 10-year inflation-indexed Treasurys, I am guaranteed to beat inflation by 2.3 percentage points a year over the next decade.

Unless I am confident that another investment will outperform this benchmark, I stick with inflation bonds. They are, to me, the investment of last resort.

Systolic BP Predicts Mortality in Acute Heart Failure

http://www.medscape.com/viewarticle/547410_print

News Author: Steve Stiles

Release Date: November 8, 2006
Systolic hypertension is not only common in patients hospitalized with acute heart failure, but it may also help protect against death while in the hospital and for several months after discharge, regardless of left ventricular (LV) systolic function at admission, suggest data from a huge multicenter registry published in the November 8 issue of JAMA. The adjusted in-hospital mortality for more than 48,000 patients hospitalized with heart failure varied inversely with their admission systolic blood pressure (SBP) and was about 4 times higher when the SBP was lower than 120 mm Hg as compared with higher than 161 mm Hg.

"Hypertension is very frequent in patients hospitalized with heart failure, including those with reduced systolic function as well as those with preserved systolic function," Gregg C. Fonarow, MD, of the University of California, Los Angeles, Medical Center, a coauthor of the analysis, told heartwire. Half of the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry cohort — more than a third of patients with LV systolic dysfunction and more than half of those with preserved LV function — had an admission SBP of more than 140 mm Hg.

The inverse relationship between admission SBP and in-hospital mortality, Dr. Fonarow observed, applied to both groups of patients. Postdischarge mortality also rose significantly with declining admission SBP, regardless of any treatment with vasodilators or inotropic agents, in a subgroup of the cohort that was followed up for 2 to 3 months.

The OPTIMIZE-HF analysis by Mihai Gheorghiade, MD, of Northwestern University in Chicago, Illinois, and colleagues, not only suggests that admission SBP is independently prognostic in patients hospitalized with heart failure, they have implications for therapy, observed Dr. Fonarow. They suggest, he said, that "with the characteristics and outcomes so different among the patients by varied SBP levels, management will need to vary. Rather than grouping all of these patients together, we'll potentially need to stratify them."

The report states that "Elevated SBP appears to signal specific pathophysiological processes that differ from the underlying processes in patients with low SBP. Because the characteristics and outcomes are different among patients with heart failure with varying SBP levels, management may need to vary according to SBP at admission."

The in-hospital outcomes analysis included patients admitted with heart failure at 259 academic and community-based US hospitals "of all sizes and from all regions of the country." In the overall cohort and the subgroup of 5791 patients followed up after discharge, admission SBP was a significant predictor of mortality after controlling for a long list of demographic, hemodynamic, renal functional, clinical, and drug treatment criteria.

For admission SBP readings lower than 160 mm Hg, the hazard ratio for in-hospital death went up 21% (95% confidence interval [CI], 1.17 - 1.25) for every 10-mm Hg drop; the risk did not vary for SBP values higher than 160 mm Hg. Also for every 10-mm Hg decrease in SBP, the postdischarge-mortality hazard ratio climbed 18% (95% CI, 1.10 - 1.26), and the hazard ratio for the composite of mortality or rehospitalization rose 5% (95% CI, 1.03 - 1.07).

Table. Outcomes by Admission SBP Quartile and LV Systolic Dysfunction (All Trends Across Quartiles, P < .001)*

Endpoint by Patient Group	<>	120 - 139 mm Hg	140 - 161 mm Hg	> 161 mm Hg
In-hospital Mortality
Overall, % (n = 48,612)	7.2	3.6	2.5	1.7
LV systolic dysfunction,%†	6.6	3.1	2.5	1.6
No. of LV systolic dysfunction, %†	6.2	3.2	2.0	1.4
Postdischarge Mortality
Follow-up cohort, % (n = 5791)	14.0	8.4	6.0	5.4
LV systolic dysfunction, %‡	13.0	6.8	6.3	4.1
No. of LV systolic dysfunction, %‡	14.9	10.0	4.7	4.7

*SBP indicates systolic blood pressure; and LV, left ventricular.
^†LV function measured in 41,267 patients overall.
^‡LV function measured in 4959 patients in the follow-up cohort.
Source: JAMA. 2006;296:2217-2226.

The average hospital length of stay also declined with rising admission SBP regardless of LV systolic functional status; in the overall group, it decreased from 6.5 days for patients with SBP lower than 120 mm Hg to 5.1 days for those with pressures higher than 161 mm Hg (P < .001). The rate of rehospitalization 60 to 90 days after discharge did not vary significantly overall or in the 2 LV systolic-function subgroups.

"Interestingly, we put so much emphasis on LV ejection fraction," Dr. Fonarow said, "and yet it's not a major determinant of clinical outcomes in these patients, whereas admission systolic blood pressure, which has not received a lot of focus, is a much larger predictor of mortality in these patients."

Disclosure statements for all coauthors are listed in the article, which also states that GlaxoSmithKline funded the OPTIMIZE-HF registry, was involved in its design and conduct, and reviewed the manuscript prior to submission but "was not involved in the management, analysis, or interpretation of data or the preparation of the manuscript."

JAMA. 2006;296:2217-2226, 2259-2260.

News Author

Steve Stiles
is a journalist for Medscape. He has been reporting on cardiovascular medicine since 1984 and for the past 3 years has been a journalist for theheart.org, a website acquired by WebMD. Steve is a graduate of Kenyon College and has an MS from the journalism department at Boston University. He can be contacted at SStiles@webmd.net.

Disclosure: Steve Stiles has disclosed no relevant financial relationships.

Irritable Bowel, Pain Syndromes Linked

http://aolsvc.health.webmd.aol.com/content/article/128/116870?printing=true

By Daniel DeNoon WebMD Medical News

Reviewed By Louise Chang, MD on Thursday, September 28, 2006

Sept. 28, 2006 -- Doctors have long suspected a link between irritable bowel syndrome, pain syndromes, and depression. New data now strongly support this theory.

The findings come from data on 97,593 people with irritable bowel syndrome enrolled in a large U.S. health plan from 1996 to 2002. J. Alexander Cole, DSc, MPH, and colleagues at Boston University compared these patients with 27,402 people seeking routine health care.

Their results show that people with irritable bowel syndrome are:

• 80% more likely to suffer fibromyalgiafibromyalgia
• 60% more likely to suffer migraine
• 40% more likely to suffer depression
• Overall, 60% more likely to suffer fibromyalgia, migraine, or depression

"Perhaps what is driving the relation between irritable bowel syndrome and these other conditions is some underlying biological disorder," Cole tells WebMD. "Nobody is sure what this could be. But people suggest that there is this constellation of symptoms among people with irritable bowel syndrome, fibromyalgia, migraine, and depression that might present in different ways."

Cole and colleagues report their findings in the Sept. 28 issue of the online journal BMC Gastroenterology.

Common Cause of Pain Syndromes?

Cole, now an epidemiologist with i3 Drug Safety, is not an expert on irritable bowel syndrome. Reza Shaker, MD, is. Shaker, chief of gastroenterology and hepatology at the Medical College of Wisconsin, was not involved in the Cole study.

"Clinical observations of patients with pain syndromes indicate that we are dealing with a syndrome bigger than a single organ," Shaker tells WebMD. "These findings confirm these previous observations."

Shaker says people with irritable bowel syndrome and people with pain syndromes such as fibromyalgia and migraine have something in common. They all have nerve pathways which somehow have become vastly oversensitive to pain signals -- a process doctors call sensitization.

Perhaps, Shaker suggests, there's a common problem at the crossroads where these nerve pathways intersect.

"Is it possible that there is an event -- possibly an early life event -- that affects the crossroads of all these nerve pathways?" he asks. "In areas where these nerves cross, it could be that there is sensitization occurring, affecting different neural circuits."

Cole suggests that different doctors looking at the same underlying illness might make different diagnoses. A gastroenterologist, for example, might diagnose irritable bowel syndrome, while a rheumatologist might diagnose fibromyalgia.

This sounds a lot like the blind men who, on first encountering an elephant, declare it to be like a snake or a tree depending on whether they are touching the elephant's trunk or its leg. Shaker says this analogy is apt. But most doctors, he says, will examine the whole elephant, not just its parts.

"A professional doesn't just focus on one symptom. If we see irritable bowel syndrome along with noncardiac chest pain or fibromyalgia, then we tackle this," he says. "But we doctors need to have a more global picture of this, instead of pigeonholing our diagnosis according to our own specialty or subspecialty."

---

SOURCES: Cole, J.A. BMC Gastroenterology, Sept. 28, 2006; vol 6: pp 26. J. Alexander Cole, DSc, MPH, epidemiologist, i3 Drug Safety. Reza Shaker, MD, chief, division of gastroenterology and hepatology, Medical College of Wisconsin, Milwaukee.

© 2006 WebMD Inc. All rights reserved.

• Antibiotic May Aid Irritable Bowel
• Irritable Bowel, Pain Syndromes Linked
• Read more in the Irritable Bowel Syndrome Center.
• Read the top health news of the day.
• Get more Irritable Bowel Syndrome news.

Menjadi Muslim Amerika

http://islamlib.com/id/index.php?page=article&id=1167

Surat Pada Seorang Kawan

Oleh Ulil Abshar-Abdalla

17/11/2006

Sistem sekuler muncul sebagai respon atas keadaan di mana sistem yang didasarkan sepenuhnya pada agama menimbulkan banyak masalah. Sistem sekuler adalah jalan tengah: antara memaksakan agama sebagai sistem yang berlaku buat semua warga negara, dan memusuhi agama sama sekali.

Kawan,
Sudah setahun lebih saya hidup di Amerika, tepatnya di negara bagian Massachusetts yang sangat “liberal”. Saya sungguh beruntung hidup di negara bagian yang liberal ini. Saya akan mencoba menunjukkan bagaimana hal itu menguntungkan bagi kami yang beragama Islam.

Di Amerika, saya sangat menggemari stasiun radio NPR, National Public Radio, atau kanal TV publik seperti WGBH di Boston. Saya memang tak melanggan kabel, sehingga hanya saluran gratis yang bisa saya nikmati. (Karena satu dan lain hal, saya tak bisa melanggan kabel, padahal saya sangat ingin bisa menikmati saluran seperti C-SPAN yang menayangkan program yang sangat bagus pada akhir minggu, terutama acara diskusi buku).

NPR adalah stasiun yang paling saya suka. Sebagaimana di Indonesia, kaum konservatif di Amerika juga sangat menyebalkan. Radio-radio swasta yang mempunyai acara "talk", banyak yang berkecenderungan konservatif. Saya tak tahan mendengarkan "ocehan" kaum konservatif yang menyebalkan itu, terutama kalau sudah menyangkut Irak, Iran, dan Israel.

NPR-lah yang menyelamatkan saya karena perspektifnya yang "liberal". Di NPR, saya bisa mendengarkan liputan yang berimbang tentang banyak hal. Setiap pihak diberikan kesempatan untuk menyuarakan perspektifnya. Keragaman programnya juga sangat memanjakan pendengar. Persis seperti kanal BBC di London. Bagi umat Islam, stasiun inilah yang paling enak didengarkan, karena tidak melanggengkan citra buruk tentang Islam yang secara klise disebarkan oleh beberapa media Amerika, terutama yang konservatif.

Tidak seperti BBC yang didanai sebagian besar oleh pemerintah melalui pajak, pendanaan NPR sebagian besar datang dari masyarakat, filantrofi, dan komersial yang sangat terbatas. Tiap tahun mereka mangadakan panggalangan dana dari pendengar, dan untuk itu, saya dengan sukarela menyedekahkan infak, walau kecil, untuk stasiun ini. Saya merasa, kepentingan saya sebagai seorang Muslim terwakili dalam stasiun itu, dan karena itu saya berkewajiban untuk menyumbang.

Selama ini, umat Islam membenci liberalisme dan sekularisme. Menurut saya, umat Islam perlu mengalami dulu status sebagai "minoritas" (secara kuantitatif), baru merasakan betapa manfaat besar yang mereka peroleh dari sistem liberal dan sekular.Bayangkan jika Amerika adalah negara Kristen, atau kebijakan-kebijakannya didasarkan pada agama Kristen, apa yang terjadi pada umat Islam di sini. Bayangkan jika Eropa, misalnya, adalah negara Kristen, bukan negara sekuler: apa yang terjadi pada umat Islam di sana?

Bayangkan jika radio atau TV Amerika semua ingin menjadi kanal atau stasiun yang "Kristiani" (padanan dari kata "Islami"); bayangkan jika kebijakan FCC (KPI-nya Amerika) memberikan status istimewa pada stasiun atau kanal yang Kristiani: apa yang terjadi pada umat Islam yang tinggal di sini? Bayangkan jika tidak ada stasiun yang "liberal" seperti NPR, yang memberikan hak suara yang seimbang kepada kalangan Islam: apa yang terjadi pada pendengar Muslim?

Masyarakat akan tahu manfaat liberalisme dan sekularisme saat mereka menjadi minoritas. Sebab, dua sistem itu secara historis memang muncul di Barat, antara lain, untuk melindungi kaum minoritas. Saat menjadi mayoritas seperti di Indonesia, memang umat Islam kurang bisa melihat atau malah sama sekali abai terhadap manfaat sekularisme dan liberalisme.

Anak saya saat ini sekolah di Public School di kawasan Newton Centre. Di sekolah, agama sama sekali tak disinggung, meskipun keragaman tradisi agama sangat dihormati. Saat menjelang bulan Ramadan kemaren, guru kelas anak saya memanggil isteri saya dan memberikan buku cerita bergambar untuk anak-anak tentang tradisi puasa dalam Islam. "You need to read this for your kids," kata guru itu. Kami sangat terharu saat itu. Apakah hal ini mungkin terjadi di Indonesia di mana kebencian pada Kristen atau agama lain dirawat pada pelbagai tingkat, misalnya?

Saat Ramadan kemaren, Perpustakaan umum yang cukup besar di kawasan Newton yang biasa kami kunjungi setiap akhir minggu (Newton Free Library) juga memajang buku-buku dan komik bergambar tentang ritual puasa dalam Islam, sehingga publik Amerika bisa memahami tradisi umat Islam itu. Ini berlaku untuk semua agama, sehingga kami yang Muslim juga bisa belajar tentang tradisi lain. Pendidikan tentang multikuralisme yang berwawasan pluralisme dikembangkan di masyarakat Amerik, sehingga mereka pelan-pelan bisa menghargai perebedaan tradisi agama.

Meskipun agama tidak menjadi bagian dari pelajaran sekolah, tetapi keragaman agama sangat dihormati di sekolah publik Amerika. Kalau keluarga Kristen menghendaki anak-anaknya untuk mendapat pelajaran agama, mereka bisa mengirim akanya ke sekolah minggu. Begitu juga umat Islam mengadakan sekolah minggu untuk anak-anak mereka. Agama menjadi urusan komunitas masing-masing. Inilah hasil dari sekularisme dan liberalisme. Dengan cara seperti ini, kami yang datang dari keluarga Muslim tidak akan merasa khawatir sedikitpun anak kami akan dijejali ajaran agama Kristen yang merupakan agama dominan di Amerika.

Bayangkan jika Amerika mendorong sekolah-sekolah publik untuk menjadi lebih Kristiani, apa yang terjadi pada kami yang Muslim? Padahal hanya di sekolah publik inilah keluarga pendatang seperti saya bisa menyekolahkan anak, karena gratis total hingga ke makan-makan siangnya.

Karena sistem sekuler yang melindungi semua agama inilah Islam bisa berkembang leluasa di sini. Semua sekte dan mazhab bisa menikmati kebebasan di sini. Sebab negara bersikap netral terhadap agama, tetapi juga mendorong sikap saling menghargai antar tradisi agama. Kaum mayoritas memang tak butuh sekularisme di mana-mana. Kalau bisa mereka menjadikan agama mereka sebagai agama seluruh bangsa. Tetapi kaum minoritas membutuhkan itu. Saat umat Islam minoritas, sistem ini menguntungkan mereka dari segala segi.

Saya mendengar kesaksian ini secara langsung dari beberapa komunitas Muslim di Paris saat saya berkunjung ke sana dua tahun lalu. Meskipun ada masalah dengan jilbab di sana, komunitas Muslim merasa bahwa negara sekuler Perancis sangat menguntungkan buat mereka, karena mereka bisa menjalankan agama dengan bebas. Bandingkan keadaan ini dengan Perancis pada periode sebelum abad 20. Pada saat itu, jangankan orang Islam: orang Prostestan menghadapi tekanan, diskriminasi, pelecehan, bahkan penyiksaan yang hebat dari agama Katolik yang dominan.

Kaum pejuang negara Islam bisa berkata, misalnya: dalam Islam juga ada kebebasan agama; dalam sejarah, Islam bisa memberikan toleransi yang luas pada agama lain. Umat Muslim diberikan status "dzimmi" dan dengan status itu mereka menikmati kebebasan untuk menyelenggarakan agama mereka.

Jawaban saya adalah sebagai berikut. Dibanding dengan agama Kristen, secara historis Islam memang memperlakukan agama lain dengan cara yang jauh lebih toleran pada abad pertengahan. Tetapi sistem toleransi yang dipraktekkan Islam pada masa lampau sudah tak memadai saat ini. Kita memberikan kredit pada Islam untuk "prestasi historis" yang telah ia capai; tetapi, mohon maaf, zaman telah berubah, dan sistem toleransi Islam sudah kalah jauh dibanding dengan sistem toleransi dalam sistem sekularisme liberal. Lihatlah perbandingan berikut ini.

Bayangkanlah situasi berikut ini. Kalau anda sebagai umat Islam yang tinggal di Amerika diminta untuk memilih antara kedua opsi ini:

(1) Negara Amerika menjadi negara Kristen atau menjadikan agama Kristen sebagai agama negara dan memberikan kepada agama Kristen pengaruh yang besar, dengan janji bahwa agama Kristen akan memberikan kebebasan pada agama lain.

(2) Negara Amerika menjadi negara sekuler; negara bersikap netral terhadap agama apapun, tetapi menghargai semua agama, memberikan kebebasan kepada semua pemeluk agama untuk beribadah dan memeluk kepercayaan sesuai dengan keyakinan masing-masing.

Sebagai umat minoritas, jelas pilihan kedua lebih masuk akal bagi umat Islam. Pilihan pertama, meskipun dengan janji bahwa Kristen akan memberikan toleransi pada agama-agama lain, tetap tak ada jaminan bahwa dalam agama lain tidak dijadikan sebagai agama kelas dua.

Begitu juga keadaan ini berlaku buat umat lain dalam negara yang mayoritas Muslim seperti di Indonesia. Meskipun umat Islam mengobral janji bahwa Islam akan memberikan kebebasan pada semua agama ketika dijadikan sebagai agama negara atau ketika negara bersangkutan menjadi negara Islam, atau ketika syariat dijalankan, tetap saja buat kalangan non-Muslim akan lebih aman jika sebuah negara menjadi negara sekuler, dalam pengertian tak mencampuri urusan agama. Persis seperti umat Islam di Amerika merasa lebih aman pada Amerika sebagai negara yang netral pada agama.

Menurut saya, jika suatu negara menjadi negara Islam atau menjalankan syariat Islam, kemungkinan untuk mempersekusi atau mendiskriminasi sekte-sekte yang dianggap keluar dari Islam akan selalu terjadi. Itu sudah hukum sejarah. Bangsa Eropa dulu sudah pernah mengalami itu. Sekarang, bangsa Indonesia pelan-pelan mengikuti contoh yang sudah ditinggalkan lama oleh Eropa itu, yakni mempersekusi sekte minoritas, ya'ni Ahmadiyah. Saya bukan seorang Ahmadiyah, tetapi kasus Ahmadiyah saya jadikan sebagai contoh, karena paling relevan untuk keadaan Indonesia saat ini.

Para pejuang syariat Islam harus menghadapi pertanyaan besar ini: kalau menurut syariat Islam (ortodoks Sunni), orang yang mempercayai pendiri gerakan Ahmadiyah dianggap sebagai Nabi dianggap kafir dan keluar dari Islam, lalu anda ingin melaksanakan syariat Islam, tentu dengan sendirinya saat syariat itu tegak, anda akan mengusir atau minimal membatasi gerak orang Ahmadiyah, sebab mereka adalah orang kafir.

Bandingkan dengan sistem sekuler: dalam sistem itu, karena negara netral terhadap agama, sekte, dan denominasi, orang Ahmadiyah bisa bergerak bebas mendakwahkan ajaran mereka. Kebebasan ini juga berlaku buat sekte atau mazhab yang lain: Syiah, kelompok tasawwuf dari orde apapun. Kebabasan ini juga berlalu buat semua agama. Itulah sistem yang sekarang berlaku di Amerika.

Jika anda memperbandingkan kedua sistem itu, jelas sistem sekuler lebih unggul. Keunggulan ini tidak bisa dirasakan kecuali oleh kelompok-kelompok yang kebetulan minoritas. Karena itu, umat Islam perlu merasakan dulu keadaan sebagai kaum minoritas dalam sistem sekuler yang liberal.

Saya sengaja memberi kualifikasi "liberal" pada kata sekuler ini, sebab ada sistem sekuler yang sama sekali tidak liberal. Contoh yang paling baik adalah Uni Soviet sebelum keruntuhannya dulu. Negara Soviet dulu jelas sekuler, tetapi tidak liberal, karena sangat memusuhi agama, termasuk Islam. Negara Cina adalah contoh lain: negara ini sekuler, tetapi mempunyai sikap yang kurang bersahabat pada agama.

Tentu tidak ada sistem yang sempurna penuh, sebab sorga tak mungkin ditegakkan di bumi ini. Sorga hanya ada di alam lain. Tetapi, manusia terus mengupayakan perbaikan atas sistem dan lembaga sosial yang mengatur kehidupan mereka. Sistem sekuler muncul sebagai respon atas keadaan di mana sistem yang didasarkan sepenuhnya pada agama menimbulkan banyak masalah. Sistem sekuler adalah jalan tengah: antara memaksakan agama sebagai sistem yang berlaku buat semua warga negara, dan memusuhi agama sama sekali. Sistem sekuler menghendaki negara yang netral terhadap agama, tetapi sekaligus mengembangkan sikap saling menghargai antar agama.

Dalam sistem seperti inilah, umat Islam yang minoritas bisa menikmati kehidupan agama yang nyaman di negeri seperi Amerika. Bahkan Islam termasuk agama yang paling cepat tumbuh di negeri itu. Apakah mungkin hal ini terjadi jika Amerika menjadi negara Kristen?

Saya melihat tidak ada pertentangan apapun antara Islam dan konsep negara sekuler dalam pengertian netral terhadap agama. Dalam negara seperti inilah cita-cita kebebasan agama dan sekaligus perlindungan agama sebagaimana dikehendaki oleh Islam dapat tercapai, jauh lebih baik ketimbang dalam negara yang ingin mengatur dirinya berdasarkan syariat Islam. Tentu, “syariat” di sini dalam pengertian yang dipahami secara konservatif selama ini.

Referensi: http://islamlib.com/id/index.php?page=article&id=1167

Bush, Islam, dan Barat

http://www.kompas.co.id/kompas-cetak/0611/17/opini/3100892.htm

Jumat, 17 November 2006

R u m a d i

Rencana kunjungan kenegaraan Presiden Amerika Serikat George W Bush awal pekan depan (20/11/2006) benar-benar menyita energi banyak pihak. Pemerintah Indonesia dan aparat keamanan sibuk luar biasa mempersiapkan tempat penyambutan dan jaminan keamanan. Istana Bogor dan Kebun Raya Bogor yang akan dijadikan tempat penyambutan Bush juga berbenah, termasuk pembuatan landasan helikopter.

Media massa begitu gencar melaporkan berbagai efek sosial yang diakibatkan kunjungan itu, seperti penutupan jalan di sekitar Kebun Raya Bogor, kantor-kantor yang harus tutup, sekolah yang harus diliburkan, dan sebagainya. Di luar itu, beberapa organ gerakan Islam menggelar berbagai demonstrasi menentang kedatangannya. Suara penolakan kehadiran Bush di Indonesia sudah menggema di mana-mana. Bahkan, sebuah bom yang diduga sebagai teror menjelang kedatangan Bush juga sudah diledakkan di sebuah restoran cepat saji di Kramat Jati, Jakarta Timur, Sabtu (11/11).

Menurut mereka, Bush bukanlah tamu yang layak dihormati. Mereka begitu marah dengan kebijakan-kebijakan luar negeri Bush yang selalu mencurigai umat Islam sebagai teroris. Tangan Bush dianggap berlumuran darah karena kebijakannya menyerang Afganistan, Irak, dan mendukung agresi Israel ke Lebanon beberapa waktu lalu, dan sebagainya.

Memang agenda kunjungan Bush ke Indonesia tidak mengagendakan masalah agama seperti kunjungannya pada 2003 lalu. Namun, sentimen keagamaan tampaknya begitu tinggi dalam "penyambutan" kunjungan Bush. Hal ini bisa dilihat dari antusiasme sebagian masyarakat yang bergerak mengerahkan energi keagamaannya untuk menolak kedatangan Bush. Gerakan ini tentu tidak akan memengaruhi kunjungan itu, tetapi secara politis jika Pemerintah Indonesia tidak mengontrol gerakan ini akan menimbulkan citra yang kurang baik bagi Indonesia.

AS dan Islam politik
Pemerintahan Bush di AS sendiri sekarang dalam posisi yang tidak menguntungkan, menyusul kekalahan Partai Republik dalam pemilu sela di AS, Selasa (7/11/). Kini Kongres AS dikendalikan sepenuhnya oleh Partai Demokrat, sehingga Bush tidak akan seleluasa ketika House of Representatives (DPR) dan Senat dikuasai kalangan Republik.

Terlepas dari kenyataan tersebut, pertanyaan yang muncul adalah mengapa gerakan Islam tertentu di Indonesia begitu tidak menyukai Bush dan pemerintahannya? Pertanyaan ini bisa dijawab pertama- tama dengan memosisikan masalah tersebut dalam konteks yang lebih luas menyangkut hubungan Islam dan Barat. Jadi masalahnya bukan sekadar kebijakan luar negeri pemerintahan Bush, terutama dalam melihat Islam, tetapi menyangkut konteks yang lebih luas.

Untuk mendiskusikan hal ini kita bisa melihat bagaimana kebijakan AS terhadap Islam. Dalam pandangan Fawas A Gerges (1999), setidaknya ada tiga hal yang mendasari posisi AS terhadap Islam politik. Pertama, AS tidak ingin terlihat tak bersahabat bagi negara-negara Islam, karena hal ini akan memperburuk sikap mereka terhadap AS. Para pejabat AS tidak mau mengulangi kesalahannya dalam menghadapi Revolusi Iran. Kedua, AS ragu-ragu untuk secara terbuka mendukung kelompok Islam mana pun, kecuali jika menguntungkan kepentingan-kepentingan regionalnya.

Ketiga, di dalam lingkaran pembuat kebijakan luar negeri AS terdapat ketidakyakinan tentang kemungkinan terjadinya hubungan baik antara Islam dan demokrasi. Mereka masih ragu-ragu apakah Islam secara doktrinal selaras dengan demokrasi dan secara kultural bisa menjadi ladang persemaian demokrasi.
Tiga proposisi tersebut kemudian membelah opini akademik AS dalam dua titik ekstrem: konfrontasionalis dan akomodasionis. Kubu konfrontasionalis melabeli aktivis Islam sebagai "fundamentalis Islam" dan menganggap Islam dan demokrasi dalam praktiknya berlawanan. Kaum fundamentalis Islam, dalam pandangan kelompok ini, sudah antidemokrasi dan anti-Barat sejak lahirnya. Intelektual AS yang berdiri di kelompok ini, antara lain Samuel P Huntington, Daniel Pipes, dan Bernard Lewis. Mereka meyakini bahwa persaingan Islam dan Barat bukan sekadar urusan materi dan kepentingan politik, tetapi juga pertarungan budaya dan peradaban. Cara pandang konfrontasionalis merekomendasikan kebijakan Pemerintah AS untuk mencegah masuknya fundamentalis Islam dan menganggap bahwa mereka yang telah berada di Barat berpotensi melakukan kekerasan.

Sedangkan kelompok akomodasionis menolak kubu konfrontasionalis yang menggambarkan Islam sebagai anti-Barat dan antidemokrasi. John L Esposito dan Leon T Hadar yang berada dalam kubu ini menjelaskan bahwa cara pandang konfrontasionalis terlalu didominasi oleh tindakan-tindakan keras kelompok kecil dan mengecilkan peran gerakan nonpolitis yang moderat. Cara pandang demikian juga terlalu monolitik dan mereduksi konflik-konflik yang ada di dunia sebagai konflik Islam-Kristen. Menurut kubu akomodasionis, Islam tidak anti-Barat dan demokrasi karena dalam Islam sendiri banyak interpretasi politis yang bisa saling berlawanan. Singkatnya, Islam tidak bisa dipandang secara monolitik.

Kelompok ini merekomendasikan kebijakan agar AS tidak menentang penerapan hukum Islam dan gerakan Islam sejauh tidak mengganggu kepentingan AS. Gelombang gerakan Islamis harus dilihat sebagai tantangan, bukan ancaman bagi AS. Akomodasionis juga meminta kepada Pemerintah AS lebih mengenali, menerima, dan menoleransi perbedaan-perbedaan ideologis antara Barat yang Kristen dan Islam. Kebijakan konfrontasi agaknya yang lebih dipilih George W Bush dalam politik luar negerinya, terutama pascaperistiwa 9/11. Dengan jargon perang melawan terorisme, AS di bawah kendali Bush seperti banteng ketaton yang melabrak siapa saja yang dianggap sebagai musuh.

Respons kemarahan sebagian penduduk dunia, terutama gerakan Islam politik, sebenarnya dapat dilihat dari perspektif ini. Perlawanan itu semakin kuat karena sejarah relasi Islam dan Barat memang lebih banyak berada dalam situasi ketegangan daripada kerja sama.

Lebih adil melihat Islam
Dari sini, apa yang bisa dimaknai dari kunjungan Bush ke Indonesia? Barat tetap memandang Indonesia sebagai negara berpenduduk Muslim terbesar di dunia mempunyai posisi penting. Oleh karena itu, meski kunjungan Bush tidak mengagendakan pembicaraan tentang agama dan terorisme, tetapi untuk menjaga kepentingan AS di kawasan Asia Tenggara isu agama tetap sangat penting. Bahkan, di tengah kekalahan Partai Republik dalam pemilu lalu, Pemerintah Indonesia justru bisa memanfaatkan untuk lebih kuat menyuarakan sikap dan pendapat agar AS bisa lebih adil dalam melihat Islam.

Terakhir, betapapun kita tidak suka dengan kebijakan politik luar negeri Bush, bahkan (sebagian) kita menganggap dia sebagai musuh, tetapi adalah keliru kalau ketidaksukaan itu kemudian menjadikan kita gelap mata. Tamu tetaplah tamu yang harus dihormati betapapun kita tidak suka.

R u m a d i Peneliti The Wahid Institute dan Staf Pengajar Fak Syariah dan Hukum UIN Syarif Hidayatullah, Jakarta

Menyemai Islam yang Indonesiawi

http://www.kompas.co.id/kompas-cetak/0611/17/opini/3101027.htm

Jumat, 17 November 2006

Zuhairi Misrawi

Ledakan bom di Kramat Jati, Jakarta Timur, beberapa hari lalu menyisakan kegelisahan. Kendatipun bom yang diledakkan M Nuh masuk dalam kategori kecil, peristiwa tersebut tetap merupakan pesan dan simbol anti-Amerika. Pertanyaannya, apakah sikap ekstrem dengan merakit dan meledakkan bom di tempat-tempat umum, yang memakan korban sebagian besar adalah umat seagama dan sebangsa, dapat dibenarkan?
Tentu saja, secara otomatis kita semua akan memberikan jawaban bahwa tidak sepatutnya seorang yang memahami ajaran agama dengan baik dan benar melakukan tindakan teror dan aksi kekerasan lainnya.
Masalah utama yang perlu mendapat perhatian dari pelbagai pihak adalah fenomena menguatnya ekstremisme. Khaled Abou el-Fadl dalam The Great Theft: Wrestling Islam from the Extremists menuturkan bahwa gerakan ekstremis yang berbasis agama makin menguat. Kendatipun jumlah mereka relatif sedikit, tetapi mereka mempunyai pengaruh yang cukup besar.

Moderatisme vs ekstremisme
Secara sosiologis, sikap ekstrem yang dilakukan oleh sebagian kelompok tidak semata-mata merupakan dorongan agama, melainkan mempunyai akar-akar sosiologis. Yang paling kentara adalah faktor modernitas yang melahirkan pseudoliberalisasi, yaitu liberalisasi yang makin menyengsarakan rakyat. Ada agenda tersembunyi di balik liberalisasi yang tidak sejalan dengan visi dan misi agama untuk pembebasan dan keberpihakan terhadap mereka yang miskin. Karena itu, menurut Khaled, sikap ekstremis merupakan sebuah sikap perlawanan terhadap modernitas.

Di samping itu, munculnya ekstremisme berkaitan dengan arus besar indoktrinisasi faham keagamaan yang bernuansa kekerasan, seperti faham bunuh diri dan terorisme. Di era teknologi ini, pengaruh-pengaruh luar amat mudah diakses oleh publik di Tanah Air. Akibatnya, faham keagamaan yang bernuansa kekerasan makin mudah memengaruhi mereka yang tidak mempunyai faham keagamaan yang mendalam.

Di sini dalam konteks keindonesiaan diperlukan pemikiran besar, terutama dalam rangka merancang-bangun keberagamaan moderat yang bersumber dari teks-teks keagamaan yang mampu menyesuaikan diri dengan konteks dan lokalitas. Faham keagamaan yang mempunyai orientasi pada kemanusiaan dan moralitas.
Muhammad Thahir bin ’Asyur dalam Maqâshid al-Syarî'ah menyatakan bahwa upaya mewujudkan kehidupan yang adil dan damai merupakan tujuan utama dari agama, terutama Islam.

Dalam hal ini, praktik keagamaan kalangan Muslim Indonesia sesungguhnya mempunyai keistimewaan tersendiri dalam rangka membangun keberagamaan yang moderat, serta menolak ekstremisme. Adanya kontrak politik di antara umat Muslim dengan umat-umat agama lain dalam Pancasila dan UUD 1945 menunjukkan salah satu bukti kuatnya sikap moderat, terutama dalam rangka membangun kebersamaan di tengah kebhinnekaan. Di sinilah masyarakat Muslim Indonesia mempunyai kekhasan tersendiri, terutama bila dibandingkan dengan masyarakat Muslim di negara lainnya.

Karenanya, sikap moderat mempunyai tujuan yang amat mulia untuk membangun toleransi dan kebersamaan. Tentu saja, yang masih harus diperjuangkan secara terus-menerus adalah memperkecil volume kebencian dan kekerasan antara sesama anak bangsa.

Indonesiawi
Dalam konteks kebangsaan, kita semua mempunyai tanggung jawab yang amat berat agar capaian-capaian yang telah diraih oleh para pendiri bangsa ini dapat terus dipelihara. Di sinilah arti penting prinsip, menjaga masa lalu yang sudah baik, dan mengambil hal-hal masa kini yang lebih baik. Khazanah masa lalu berupa keislaman yang indonesiawi sebagaimana diwariskan para pendahulu kita harus dijadikan sebagai modal untuk mempererat kebangsaan dan menjunjung tinggi kemanusiaan. Dalam kurun waktu yang cukup panjang, bangsa ini bisa hidup damai dalam kebhinnekaan. Karena itu, jalan untuk menyemai hidup damai dalam pluralitas tersebut adalah mengembangkan faham keagamaan yang bernuansa moderatisme dan mengubur faham keagamaan yang bernuansa ekstremisme. Apalagi sebagian besar, kalangan Muslim Indonesia, adalah moderat, maka modal ke arah itu sangat besar.
Zuhairi Misrawi Intelektual Muda NU

"Impact from the Deep" : Pandangan Baru Kepunahan Massal dalam Sejarah Bumi

Posted on FPK maling list, November 17, 2006

Awang Satyana

“Deep Impact” kita tahu adalah judul sebuah film terkenal yang menceritakan bagaimana sebuah komet/asteroid bisa memunahkan kehidupan di Bumi. Tetapi,“Impact from the Deep” adalah judul sebuah teori baru yang pada intinya menyatakan bahwa kepunahan masal justru datang dari Bumi sendiri.

Kepunahan massal (mass extinction) selalu menarik untuk dikaji. Telah cukup banyak buku dan artikel ilmiah ditulis untuk menampung argumen-argumen yang ada. Simposium khusus pun telah beberapa kali diadakan, terutama setelah teori Alvarez dikemukakan pada tahun 1980. Walter dan Luis Alvarez, pasangan anak-bapak (anaknya ahli geologi, bapaknya ahli fisika) mengemukakan teori bahwa dinosaurus punah pada Kapur Akhir 65 Ma (million years ago) akibat Bumi dihantam sebuah komet (deep impact). Teori ini kemudian terbukti benar karena banyak bukti fisik di lapangan ditemukan akibat benturan itu : a.l. (1) lapisan iridium ditemukan di mana-mana di seluruh dunia pada lapisan berumur 65 Ma (di Indonesia belum ada yang menelitinya), (2) impact debris, termasuk semua batuan dengan ciri petrografi pressure-shocked tersebar di seputar globe (3) kawah benturan (impact crater) berumur 65 Ma ditemukan terkubur di Semenanjung Yucatan Mexico yang disebut Kawah Chicxulub. Unsur Iridium langka ditemukan di Bumi, tetapi berlimpah di extra-terrestrial bodies seperti meteor, komet, dan asteroid. Berdasarkan lebar kawah Chicxulub, ditaksir komet/asteroid pemusnah kaum dinosaurus itu berdiameter 10 km.

Karena kepunahan di K-T (Kapur-Tersier) boundary itu terbukti benar oleh extra-terrestrial impact, maka setiap periode kepunahan di Bumi selalu dihubungkan dengan hantaman komet/asteroid. David Raup, paleontologist penulis buku “Extinctions : Bad Genes or Bad Luck ?” (terbit awal 1990an) menyatakan
begitu, memang impacts selalu disalahkan sebagai penyebab major extinctions, penyebab lain mungkin ada, tetapi tak dominant. Apakah benar begitu ?

Paling tidak, di dalam 500 juta tahun terakhir ini bisa kita catat telah terjadi lima kali kepunahan massal yang besar : (1) pada 443 Ma (ujung Ordovisium), (2) pada 374 Ma (ujung Devon), (3) pada 251 Ma (ujung Perem), (4)pada 201 Ma (ujung Trias),dan (5) pada 65 Ma (ujung Kapur). Kepunahan pada 251 Ma (ujung Perem atau ujung Paleozoikum) adalah kepunahan terbesar yang menghapus 90 % penghuni lautan dan 70 % penghuni daratan bahkan sampai sekecil serangga pun. Kepunahan ujung Perem adalah “great dying” atau “the mother of mass extinction” tulis Douglas Erwin di majalah Scientific American edisi Juli 1996. Apakah kepunahan Permian ini juga akibat asteroid impact ? Peter Ward, profesor biology-earth and space sciences dari University of Washington melaporkan penemuan baru tentang kepunahan masal terbesar di ujung Permian ini (Scientific American, Oktober 2006, p. 42-49).

Lima tahun lalu, sekelompok ahli geologi dan ahli kimia organik mulai mempelajari kondisi-kondisi lingkungan pada masa-masa kritis dalam sejarah Bumi. Pekerjaan mereka meliputi mengekstraksi residu zat kimia dari lapisan-lapisan berumur tertentu berusaha mencari fosil molekuler kimiawi yang dikenal sebagai biomarker yang ditinggalkan organisme yang telah punah. Karena kuatnya, suatu biomarker masih terawetkan di sedimen2 meskipun jazad organismenya telah lenyap meluruh. Analisis biomarker telah biasa dilakukan di petroleum geochemistry.

Biomarker ini merupakan kunci ke pengetahuan kondisi seperti apa yang terjadi di Bumi pada saat kehidupan suatu organisme berlangsung. Sampling dan penelitian telah dilakukan pada periode-periode kepunahan masal. Dan para ilmuwan tersebut mendapatkan kejutan bahwa data dari periode2 mass extinction selain pada periode K-T boundary, selalu menunjukkan kondisi lingkungan yang menunjukkan bahwa lautan2 purba telah beberapa kali berada pada kondisi kandungan oksigen yang sangat rendah (anoxia). Bersamaan dengan kondisi ini ditemukan biomarker dalam jumlah besar berupa green sulfur bacteria yang bisa melakukan fotosintesis. Pada zaman sekarang, bakteri sejenis itu ditemukan berupa green-purple sulfur bacteria di tempat2 dalam laut stagnant seperti Laut Hitam yang mengoksidasi H2S sebagai sumber energinya dan mengubahnya menjadi belerang. Gas H2S adalah gas beracun bagi banyak makhluk hidup. Kelimpahan bakteri ini pada periode2 kepunahan massal yang seperiode dengan turunnya kandungan oksigen secara ekstrim telah membuka wawasan baru tentang penyebab kepunahan masal.

Para ilmuwan telah tahu bahwa pada setiap periode kepunahan masal level oksigen selalu lebih rendah daripada biasanya. Juga, mereka tahu bahwa banyak volkanisme terjadi pada setiap periode kepunahan masal volkanisme adalah teori tandingan asteroid impact bagi kepunahan masal. Volkanisme bisa meningkatkan CO2 di atmosfer, mengurangi kadar oksigen, dan menyebabkan global warming. Tetapi, volkanisme dan berlimpahnya CO2 di atmosfer tak langsung menjelaskan punahnya banyak hewan laut pada ujung Permian juga punahnya tanaman darat, justru tanaman darat akan berlimpah dengan banyaknya CO2. Lalu, apa hubungan antara kelimpahan sulfur bacteria, depleted oxygen, volkanisme yang meningkat, global warming dan kepunahan masal ? Adakah kaitan satu dengan yang lainnya, bagaimana ?

Kuncinya ternyata ada di biomarker. Biomarker dari oceanic sediments berumur ujung Permian dan juga dari batuan Trias akhir menghasilkan bukti kimia tentang adanya suatu kelimpahan yang luar biasa bakteri pengkonsumsi H2S di lautan-lautan Permian dan ujung Trias. Karena mikroba ini hanya dapat hidup di lingkungan yang bebas oksigen (an-aerob) tetapi tetap membutuhkan cahaya Matahari untuk melakukan fotosintesis, keberadaan bakteri ini di suatu lapisan batuan Permian mengindikasikan bahwa lingkungan laut pada saat itu adalah juga suatu marker yang menunjukkan laut tanpa oksigen tetapi kaya H2S.

Di lautan-lautan sekarang, keterdapatan oksigen dan H2S terjadi dalam keadaan setimbang. H2S terdapat di tempat2 dalam di wilayah yang stagnan. Di kawasan H2S yang beracun ini hidup organisme pencinta H2S tetapi pembenci oksigen. Hal yang unik, karena sirkulasi air, oksigen berdifusi ke bawah, sedangkan H2S berdifusi ke atas, akhirnya lapisan oksigen dan lapisan H2S bertemu di tengah di suatu level yang disebut ’chemocline’ yang bisa setimbang, tetapi bisa juga terganggu. Gangguan atas batas chemocline ini bisa berakibat dahsyat dan inilah yang terjadi di ujung Permian yang menyebabkan kepunahan masal yang paling besar dalam episode sejarah Bumi.

Perhitungan oleh dua ahli geologi dari Pennsylvania State University : Lee Kump dan Mike Arthur enunjukkan apabila level oksigen drop di lautan, kondisinya akan sangat menguntungkan bakteri an-aerob dari tempat dalam, yang akan menghasilkan sejumlah besar gas H2S. Dalam perhitungannya, bila konsentrasi H2S laut dalam ini melampaui batas kritis selama periode oceanic anoxia (laut miskin oksigen), maka lapisan chemocline akan mengerucut ke atas (seperti gejala water coning) dan akhirnya semburan gas H2S beracun dari tempat dalam akan masuk ke atmosfer.

Studi Kump dan Arthur menujukkan bahwa pada penghujung Permian telah terjadi toxic H2S gas upwelling yang telah menyebabkan kepunahan di daratan dan lautan. Kemudian, model yang dibangun oleh Pavlov dari University of Arizona menunjukkan bahwa semburan H2S Permian ini telah merobek lapisan ozon Bumi pada Permian sehingga radiasi ultraviolet (UV) yang mematikan menerobos masuk membunuh setiap makhluk hidup di daratan dan lautan. Bukti terhadap model ini datang dari fosil spora berumur ujung Permian di Greenland, yang menunjukkan deformitas (perubahan bentuk) akibat exposure terhadap high level of UV.

Kump dan Arthur menghitung bahwa jumlah gas H2S yang memasuki atmosfer di ujung Permian itu 2000 kali lebih banyak daripada yang dierupsikan oleh semua gunung api2 sekarang. Efek mematikan H2S meningkat seiring naiknya temperatur, bila pada saat yang sama terjadi greenhouse effect dan global warming, maka permusnahan akan semakin efektif ! Urutan model pemusnahan dengan cara ini adalah sebagai berikut : (1) kegiatan volkanik yang meningkat melepaskan CO2 dan metan ke atmosfer, (2) rapid global warming, (3) laut yang menghangat akan mengurangi daya serap oksigen dari atmosfer ke laut, (4) terjadi kekurangan oksigen anoxia di lautan, (5) keadaan anoxia akan mengganggu kesetimbangan chemocline. chemocline yang semula datar menjadi mengerucut dengan kolom dissolved oxygen berkurang sedangkan dissolved H2S meningkat, terjadi H2S upwellling, (6) green & purple sulfur bacteria berlimpah sementara mahkluk lautan yang bernafas dengan oksigen musnah akibat hilangnya oksigen dan naiknya gas H2S yang beracun, (7) gas H2S yang menyembur membunuh makhluk daratan, (8) gas H2S naik terus ke atmosfer dan akhirnya merobek perisai ozon, (9) radiasi UV menerobos via celah di perisai ozon membunuh kehidupan di Bumi yang masih tersisa, (10) kepunahan masal.

Mekanisme pemusnahan kehidupan seperti di Permian dan Triassic telah terjadi, apakah kelak bisa terjadi lagi ? Kepunahan hebat pada ujung Permian terjadi pada saat kadar CO2 di atmosfer telah mencapai sekitar 3000 ppm, kadar CO2 di atmosfer kita sekarang berada pada 385 ppm. Apakah kita tidak perlu takut ? Tunggu dulu, kepunahan pada ujung Triassic terjadi pada saat CO2 di level 1000 ppm, dan CO2 kita sekarang meningkat 2-3 ppm setiap tahun. Bila dihitung secara linier peningkatan itu akan kita temukan bahwa pada tahun 2200 nanti kadar CO2 di atmosfer kita bisa mendekati 900 ppm suatu kondisi yang sangat bisa mendorong keadaan stress anoxia di lautan dan rentetan efek2 mematikan berikutnya seperti ditulis di atas.

The past is the key to the future. Bumi menyediakan catatan hariannya, semoga kita bisa arif membacanya buat kepentingan kehidupan masa mendatang.

Awang Satyana "Milis GeoUnpad"

Why Intelligent Design Will Win

by Nancy Pearcey
Posted Nov 30, 2005

To hear some conservatives talk, there is no room for proponents of intelligent design (ID) in the "big tent." In recent months commentators such as John Derbyshire in National Review and George Will and Charles Krauthammer in the Washington Post have inveighed against ID. Warning that "the conservative coalition" is coming unglued, Will all but called on "the storm-tossed and rudderless Republican Party" to repudiate the ID movement.

Conservatives who hope to be on the winning side, however, may want to put their money on ID, even if they harbor a few reservations at present. Here's why. For starters, the affirmation of design is good for science. Like all knowledge, science is a pattern-seeking project. The human mind inherently seeks intelligible order. Thus the conviction that such an order exists to be found is a crucial assumption. No scientists are going to find their work diminished because they ground it in the search for an inbuilt design in nature.

Indeed, as sociologist Rodney Stark argues in To the Glory of God, modern science could have arisen only in a culture convinced that the universe is the creation of a rational mind--and is thus intelligible to our rational minds. This explains why science arose historically in medieval Europe, a period when western civilization was saturated with Christianity. Steve Fuller, a sociologist of science, offers this as one reason he testified for ID in the recent court case in Dover, Pa. "The idea that religion provided intellectual sustenance for science," he explained on a recent blog, is "obviously borne out by history."

By contrast, Darwinist theory claims that the design in nature is not real but only apparent, a product of blind, mechanical forces. As arch-Darwinian Richard Dawkins said in a recent Salon interview, evolution produces "the illusion of design." The implication for science, as Richard Rorty elaborates so clearly, is that truth is not "out there" to be discovered but is merely a social construction. Such postmodernist notions threaten to undercut the scientific enterprise.

The second reason ID will win is that, contrary to the way it is often portrayed, it does not thrive on "gaps" in science but rather on the growth of science. The argument from design first became popular during the scientific revolution, which revealed that nature is more intelligible than anyone had hitherto imagined. And the current resurgence of ID was spawned by the revolution in biochemistry, which revealed the complex engineering and information processing that goes on within the cell.

We now know that the cell bristles with molecular machinery far more complicated than anything devised by mere humans. Each cell is akin to a miniature factory town, humming with power plants and automated factories, connected by criss-crossing transport rails and directed by a headquarters (the nucleus) housing a library of coded blueprints. The more we learn about life, the less plausible is any evolutionary theory that relies on blind, undirected, piece-by-piece change.

Third, ID will win because it incorporates the insights of the high-tech world of information theory. The revolution in biochemistry revealed that the core of living things is a code, language, information (DNA). The origin of life has now been recast as the origin of complex biological information. This explains why laboratory experiments to create life have failed—because they work from the bottom up, by assembling the right materials. But life is not fundamentally about matter; it’s about information.

In today's preferred analogy, the DNA molecule is the hardware, while the information stored and transmitted is the software. "Trying to make life by mixing chemicals in a test tube," writes astrophysicist Paul Davies, "is like soldering switches and wires in an attempt to produce Windows 98. It won't work because it addresses the problem at the wrong conceptual level.” The paramount role of information strongly suggests that mind preceded matter.

Fourth, ID will win because it recovers the unity of truth. Edward Purcell in The Crisis of Democratic Theory: Scientific Naturalism and the Problem of Value explains how Darwinism led to a naturalistic worldview--one in which the natural sciences were elevated to the only form of objective knowledge while "theological dogmas and philosophical absolutes were at worst totally fraudulent and at best merely symbolic of deep human aspirations." In other words, Darwinism lent scientific support to the fact/value dichotomy, where religion and morality are dismissed as merely subjective and private, or even outright false.

As a result, ID appeals to a broad range of people concerned about overcoming the fact/value split--especially relevant during the Christmas season, when the ACLU and assorted secularists try to impose their gospel of privatized religion onto the rest of the country. As Richard John Neuhaus wrote recently in First Things, not just conservative Protestants but also "Catholics and everyone else have an enormous stake in defending the unity of truth." BBC's Washington correspondent Justin Webb recently asked why American social conservatives "are spending more energy fighting Charles Darwin than cutting taxes," but the reason is clear: At stake is not just a scientific theory but a divided concept of truth that reduces religion and morality to the level of myth.

As though to prove the point, at Kansas University the chairman of the religious studies department, Paul Mirecki, announced a new course subtitled "Intelligent Design, Creationisms, and other Religious Mythologies." Mirecki posted a note on a student atheists website bragging that he was "doing my part to [tick] off the religious right," giving them a "slap in their big fat face by teaching [ID] . . . under the category 'mythology.'" (Mirecki has since apologized.)

Which suggests the final reason ID will win--because it accords with the ideals of a free and open society. In our pluralistic age, schools should train students in critical thinking to prepare them to engage respectfully and intelligently with a wide range of worldviews, both religious and secular. Yet under current rules, public schools may present evidence for scientific theories that imply a strictly materialistic or secular worldview, while they are not allowed to present evidence for scientific theories that imply a non-materialistic or religious worldview (though the latter may be mocked and ridiculed, as the KU course proves).

The public cannot help but notice that many ID proponents are well educated and credentialed. Yet, as attorney Doug Kern writes in Tech Central Station, "the pro-Darwin crowd insists on the same phooey-to-the-booboisie shtick that was tiresome in Mencken's day." It has grown even more tiresome in our own day.


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Copyright © 2006 HUMAN EVENTS. All Rights Reserved.

The Environment of the Economy

http://www.project-syndicate.org/print_commentary/fitoussi2/English

Jean-Paul Fitoussi

No economy is a closed, autonomous universe, governed by rules independent from law, morals, and politics. Indeed, the most interesting economic questions are generally located on the borderline with neighboring disciplines. But nowhere is this clearer than in the interaction between economic processes and the natural environment.

The distinctive feature of this exchange is that it is governed not by the laws of mechanics, but by thermodynamics, particularly the law of entropy, according to which the quantity of free energy that can be transformed into mechanical work diminishes with time – an irreversible process culminating in “heat death.” Numerous researchers, inspired by the late Nicholas Georgescu-Roegen’s pioneering work on the relationship between economic processes and physics, tried – not very successfully – to formulate an “entropic” theory of economy and society, especially during the 1970’s.

The entropic view assumes that economic processes produce irreversible consequences because of their multiple interactions with nature. We draw from stocks of non-renewable natural resources (for example, oil and metal ores), and we deteriorate or modify the quality of other resources (for example, water and arable land) by imposing on them a rhythm of exploitation superior to their capacity for regeneration. In fact, the exploitation of non-renewable resources frees the speed of economic growth from that of ecological renewal, aggravating the deterioration of the biosphere, including irreversible climate changes.

The law of entropy reminds us that we will leave to future generations a degraded natural patrimony, probably less adequate to their needs than what we inherited. Unfortunately, there are no simple answers. For the sake of what principle can we ask China and India, for example, to limit their economic dynamism so that they use smaller amounts of the planet’s natural resources? After all, the advanced countries’ slower growth is not the consequence of voluntary self-limitation, but of our superior standard of living – and of our incapacity to settle our own economic imbalances.

We cannot impose an ecological rhythm on people who are poorer than we are when it is the very fact that we freed ourselves from that rhythm that made us richer. Economic contraction, or even stagnation, is not a solution for the developed countries, either, for a similar reason: it would imply that we either accept existing inequalities or impose a regime aiming at an equal redistribution of resources. That choice boils down to an unbearable cynicism or a totalitarian utopia.

But, happily for us, our evolution is determined not only by entropy, but also by the accumulation of knowledge and technological progress – a process that is just as irreversible as the decrease in stocks of non-renewable resources and the degradation of environmental quality. Thus, the economy is entropic for resources and historical for the production, organization, and spread of knowledge, with the prospects for economic and environmental sustainability residing in the space left between those two dynamic processes: the level of growth we choose must be conditioned on a sufficient level of knowledge to ensure the system’s survival.

Yet nature, like knowledge, is a public good that needs state intervention to be “produced” in sufficient quantities. The only way to overcome the finiteness of our world is to maintain as much space as possible between entropy and history by investing in education and research aimed at increasing renewable energies, reducing the energy intensity of our standards of living, and slowing the pace of environmental erosion.

It is widely believed that such a strategy would be useless if the only effect is to allow others to get rich faster by opting out. But if that strategy is conceived as mastering two dynamic processes, overcoming the ecological constraint could be an accelerator of growth.

Jean-Paul Fitoussi is President, l’Observatoire Français des Conjonctures Économiques, Paris.

Copyright: Project Syndicate/Institute for Human Sciences, 2006.
www.project-syndicate.org