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	<title>Comments on: Is too much choice bad for the health?</title>
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	<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/</link>
	<description>Providing a clear perspective on developing science and technology responsibly</description>
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		<title>By: Hilary Sutcliffe</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32250</link>
		<dc:creator>Hilary Sutcliffe</dc:creator>
		<pubDate>Mon, 12 Oct 2009 18:05:38 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32250</guid>
		<description>Yes, you are right Ruth.  I was rather hoping to take the easy way out.  Now have to try a bit harder, but as you say, it may be better in the long run!</description>
		<content:encoded><![CDATA[<p>Yes, you are right Ruth.  I was rather hoping to take the easy way out.  Now have to try a bit harder, but as you say, it may be better in the long run!</p>
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		<title>By: Ruth Seeley</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32246</link>
		<dc:creator>Ruth Seeley</dc:creator>
		<pubDate>Mon, 12 Oct 2009 17:11:07 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32246</guid>
		<description>Your point re genuine consultation is well taken, Hilary. I would say that until the turn of the 21st C in North America anyway a form of &#039;cookie cutter consultation&#039; designed to ensure the success of corporate strategies for growth was the norm. Given the tremendous cost of doing a consultation, I was always vehemently opposed to that notion. Consultations, whether mandated by law or freely entered into, are  tremendous opportunities for learning. During the year-long community and stakeholder consultation I was involved with, we learned a tremendous about issues that were brewing that had nothing to do with the corporate strategy that was the subject matter of the consultation, as people vented in the spirit of, &#039;while I have your attention, there&#039;s another matter I&#039;d like to discuss.&#039; What I learned from the whole process was that people want to be listened to. They don&#039;t necessarily expect - or want - to have their point of view adopted, in the same way that people don&#039;t necessarily exercise their right to vote in a democracy. But take away the right to vote - or to express their views - and you run the risk of opposition consolidating and becoming an actual organized &#039;movement.&#039;

Given the lack of funding, perhaps the way forward is to ask communities to organize opportunities for consultation themselves, and merely provide access to the experts? Or perhaps create a web-enabled consultation process that doesn&#039;t involve travel, signage, renting halls, refreshments, etc.</description>
		<content:encoded><![CDATA[<p>Your point re genuine consultation is well taken, Hilary. I would say that until the turn of the 21st C in North America anyway a form of &#8216;cookie cutter consultation&#8217; designed to ensure the success of corporate strategies for growth was the norm. Given the tremendous cost of doing a consultation, I was always vehemently opposed to that notion. Consultations, whether mandated by law or freely entered into, are  tremendous opportunities for learning. During the year-long community and stakeholder consultation I was involved with, we learned a tremendous about issues that were brewing that had nothing to do with the corporate strategy that was the subject matter of the consultation, as people vented in the spirit of, &#8216;while I have your attention, there&#8217;s another matter I&#8217;d like to discuss.&#8217; What I learned from the whole process was that people want to be listened to. They don&#8217;t necessarily expect &#8211; or want &#8211; to have their point of view adopted, in the same way that people don&#8217;t necessarily exercise their right to vote in a democracy. But take away the right to vote &#8211; or to express their views &#8211; and you run the risk of opposition consolidating and becoming an actual organized &#8216;movement.&#8217;</p>
<p>Given the lack of funding, perhaps the way forward is to ask communities to organize opportunities for consultation themselves, and merely provide access to the experts? Or perhaps create a web-enabled consultation process that doesn&#8217;t involve travel, signage, renting halls, refreshments, etc.</p>
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		<title>By: Hilary Sutcliffe</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32221</link>
		<dc:creator>Hilary Sutcliffe</dc:creator>
		<pubDate>Mon, 12 Oct 2009 12:21:24 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32221</guid>
		<description>These thoughts have being doing my head in for the last year when deciding about www.nanoandme.org.  So what does information like this do for anyone, except give them yet another thing to worry about that they didn&#039;t have before. Could it inflame debate and undermine further people&#039;s trust of nano, or science or technology or companies? Is that &#039;deserved&#039; so important to shine the light?  What trumps what?

I came to the conclusion that rounded, thoughtful information which seeks to explore the issues at reasonable length, whilst remaining easy to understand and relatively fun to interact with may be better than nothing.  People are going to hear others, ngos, businesses, scientists, media telling them what nano is and isn&#039;t. So trying to give them a reference point which creates a more rounded picture and lots of links to other places for a more detailed view is perhaps a useful contribution.

Tim Jones&#039;s point about whether one is being nervous and inexpert or expert and consultative is very tricky.  With Nano&amp;me I was trying to get the balance of authority and consultation, and had no cash for focus groups.  The current &#039;expert&#039; consultation was supposed to do that job, and was to include direct requests to those members of the public who had participated in UK nano dialogue type initiatives who virtually all said they wanted more information.  Unfortunately data protection legislation meant all their email addresses had been chucked away, so we have now  to find another way to consult!

Also the point in theory of genuine consultation being that you haven&#039;t got it sorted already, which is why you are asking, so their views can inform the debate makes it trickier!

But as no-one will now fund any communications outreach for the general consumer then perhaps I&#039;ll stop worrying, as no-one will see Nano&amp;me anyway!</description>
		<content:encoded><![CDATA[<p>These thoughts have being doing my head in for the last year when deciding about <a href="http://www.nanoandme.org" rel="nofollow">http://www.nanoandme.org</a>.  So what does information like this do for anyone, except give them yet another thing to worry about that they didn&#8217;t have before. Could it inflame debate and undermine further people&#8217;s trust of nano, or science or technology or companies? Is that &#8216;deserved&#8217; so important to shine the light?  What trumps what?</p>
<p>I came to the conclusion that rounded, thoughtful information which seeks to explore the issues at reasonable length, whilst remaining easy to understand and relatively fun to interact with may be better than nothing.  People are going to hear others, ngos, businesses, scientists, media telling them what nano is and isn&#8217;t. So trying to give them a reference point which creates a more rounded picture and lots of links to other places for a more detailed view is perhaps a useful contribution.</p>
<p>Tim Jones&#8217;s point about whether one is being nervous and inexpert or expert and consultative is very tricky.  With Nano&amp;me I was trying to get the balance of authority and consultation, and had no cash for focus groups.  The current &#8216;expert&#8217; consultation was supposed to do that job, and was to include direct requests to those members of the public who had participated in UK nano dialogue type initiatives who virtually all said they wanted more information.  Unfortunately data protection legislation meant all their email addresses had been chucked away, so we have now  to find another way to consult!</p>
<p>Also the point in theory of genuine consultation being that you haven&#8217;t got it sorted already, which is why you are asking, so their views can inform the debate makes it trickier!</p>
<p>But as no-one will now fund any communications outreach for the general consumer then perhaps I&#8217;ll stop worrying, as no-one will see Nano&amp;me anyway!</p>
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		<title>By: Andrew Maynard</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32216</link>
		<dc:creator>Andrew Maynard</dc:creator>
		<pubDate>Mon, 12 Oct 2009 11:07:32 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32216</guid>
		<description>I think that&#039;s an important point that, while decision-making based on information is typically complex, the tools don&#039;t have to be - and there&#039;s a danger of confusing the two and getting in a knot.

There was a recent paper in Nature Nanotechnology talking about risk research that seemed to do something similar - confusing public engagement with quantitative risk-based research.  Both are valid, but they are complimentary - one isn&#039;t a substitute for the other.</description>
		<content:encoded><![CDATA[<p>I think that&#8217;s an important point that, while decision-making based on information is typically complex, the tools don&#8217;t have to be &#8211; and there&#8217;s a danger of confusing the two and getting in a knot.</p>
<p>There was a recent paper in Nature Nanotechnology talking about risk research that seemed to do something similar &#8211; confusing public engagement with quantitative risk-based research.  Both are valid, but they are complimentary &#8211; one isn&#8217;t a substitute for the other.</p>
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		<title>By: Andrew Maynard</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32215</link>
		<dc:creator>Andrew Maynard</dc:creator>
		<pubDate>Mon, 12 Oct 2009 11:04:29 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32215</guid>
		<description>Thanks for the link Handre</description>
		<content:encoded><![CDATA[<p>Thanks for the link Handre</p>
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		<title>By: Handre</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32190</link>
		<dc:creator>Handre</dc:creator>
		<pubDate>Mon, 12 Oct 2009 06:17:47 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32190</guid>
		<description>You might find this Ted talk interesting.

http://www.ted.com/talks/dan_ariely_asks_are_we_in_control_of_our_own_decisions.html</description>
		<content:encoded><![CDATA[<p>You might find this Ted talk interesting.</p>
<p><a href="http://www.ted.com/talks/dan_ariely_asks_are_we_in_control_of_our_own_decisions.html" rel="nofollow">http://www.ted.com/talks/dan_ariely_asks_are_we_in_control_of_our_own_decisions.html</a></p>
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		<title>By: Ruth Seeley</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32132</link>
		<dc:creator>Ruth Seeley</dc:creator>
		<pubDate>Sun, 11 Oct 2009 17:17:13 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32132</guid>
		<description>LOL, Tim - that&#039;s precisely the kind of subtlety I expect from the good doctor.</description>
		<content:encoded><![CDATA[<p>LOL, Tim &#8211; that&#8217;s precisely the kind of subtlety I expect from the good doctor.</p>
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		<title>By: Tim Jones</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32130</link>
		<dc:creator>Tim Jones</dc:creator>
		<pubDate>Sun, 11 Oct 2009 16:56:47 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32130</guid>
		<description>Hey Ruth,  Ben Goldacre very much shares your view re the expectation we don&#039;t get sick and that it&#039;s a failure of the system/profession when we do,  He was more subtle at a meet earlier this year; summary: &quot;shit happens&quot;.</description>
		<content:encoded><![CDATA[<p>Hey Ruth,  Ben Goldacre very much shares your view re the expectation we don&#8217;t get sick and that it&#8217;s a failure of the system/profession when we do,  He was more subtle at a meet earlier this year; summary: &#8220;shit happens&#8221;.</p>
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		<title>By: Tim Jones</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32128</link>
		<dc:creator>Tim Jones</dc:creator>
		<pubDate>Sun, 11 Oct 2009 16:40:18 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32128</guid>
		<description>Interesting to consider whether the  scholarly works you mention (incl. I guess products of theoretical discussions going on in academic circles) on the topic of informed publics, engagement and decision making have actually informed this topic in any practical sense.   

I wonder too if there is too much aversion to prescription in these matters of guiding folk how they might deliberate over information and formally quantify risk / relativities.  

Consider a hypothetical engagement focused website  that makes a deal of asking users whether the site itself is doing the right thing, providing the right information or level of information.  That approach can appear super-democratic and involving; but can also be seen as nervous, inexpert, and ducking of responsibility.  &#039;First round&#039; content can surely be put out with some confidence following focus group type activity?   

I guess I&#039;m thinking the most effective techniques for dealing with information  are not themselves as subjective as the decisions they inform, and should be presented as such - as tools.   

Also, that the &#039;public&#039; can be forgiven for expecting professional engagement specialists to propose some solutions to the questions like the ones you raise here - without having the issue thrown back at them.  (That&#039;s not a reference to your post here I should add!).   &#039;Authority&#039; and &#039;expert&#039;  are not dirty words and will be respected where they are convincingly demonstrated.</description>
		<content:encoded><![CDATA[<p>Interesting to consider whether the  scholarly works you mention (incl. I guess products of theoretical discussions going on in academic circles) on the topic of informed publics, engagement and decision making have actually informed this topic in any practical sense.   </p>
<p>I wonder too if there is too much aversion to prescription in these matters of guiding folk how they might deliberate over information and formally quantify risk / relativities.  </p>
<p>Consider a hypothetical engagement focused website  that makes a deal of asking users whether the site itself is doing the right thing, providing the right information or level of information.  That approach can appear super-democratic and involving; but can also be seen as nervous, inexpert, and ducking of responsibility.  &#8216;First round&#8217; content can surely be put out with some confidence following focus group type activity?   </p>
<p>I guess I&#8217;m thinking the most effective techniques for dealing with information  are not themselves as subjective as the decisions they inform, and should be presented as such &#8211; as tools.   </p>
<p>Also, that the &#8216;public&#8217; can be forgiven for expecting professional engagement specialists to propose some solutions to the questions like the ones you raise here &#8211; without having the issue thrown back at them.  (That&#8217;s not a reference to your post here I should add!).   &#8216;Authority&#8217; and &#8216;expert&#8217;  are not dirty words and will be respected where they are convincingly demonstrated.</p>
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		<title>By: Andrew Maynard</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32120</link>
		<dc:creator>Andrew Maynard</dc:creator>
		<pubDate>Sun, 11 Oct 2009 16:14:40 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32120</guid>
		<description>Ha - thanks Zeeweed!

Clearly the solution is to label nothing :-)  No information - no hard choices!

(I&#039;m being facetious, of course...)</description>
		<content:encoded><![CDATA[<p>Ha &#8211; thanks Zeeweed!</p>
<p>Clearly the solution is to label nothing <img src='http://2020science.org/wp-includes/images/smilies/icon_smile.gif' alt=':-)' class='wp-smiley' />   No information &#8211; no hard choices!</p>
<p>(I&#8217;m being facetious, of course&#8230;)</p>
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		<title>By: Andrew Maynard</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32119</link>
		<dc:creator>Andrew Maynard</dc:creator>
		<pubDate>Sun, 11 Oct 2009 16:13:48 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32119</guid>
		<description>Thanks Ruth,

I&#039;m afraid I opened a can of worms with a deceptively trite post - many of which you&#039;ve dug out and aired a little more thoroughly :-)

Dealing with information, risk, and personal and social decision-making is not easy.  There&#039;s a large academic and popular literature out there, which I conveniently ignored in the post.  But the bottom line is that, although there&#039;s a lot of talk about the problems, I don&#039;t see too many practical solutions!</description>
		<content:encoded><![CDATA[<p>Thanks Ruth,</p>
<p>I&#8217;m afraid I opened a can of worms with a deceptively trite post &#8211; many of which you&#8217;ve dug out and aired a little more thoroughly <img src='http://2020science.org/wp-includes/images/smilies/icon_smile.gif' alt=':-)' class='wp-smiley' /> </p>
<p>Dealing with information, risk, and personal and social decision-making is not easy.  There&#8217;s a large academic and popular literature out there, which I conveniently ignored in the post.  But the bottom line is that, although there&#8217;s a lot of talk about the problems, I don&#8217;t see too many practical solutions!</p>
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		<title>By: Zeeweed</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32113</link>
		<dc:creator>Zeeweed</dc:creator>
		<pubDate>Sun, 11 Oct 2009 15:34:10 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32113</guid>
		<description>Interesting post. It makes me think about how my field of work/study influences my trips to the grocery store. I consciously veer away from the snack aisle, read those zillion fine-print labels on everything to make sure they don&#039;t have hydrogenated vegetable oils or high-fructose corn syrup or MSG or preservatives/chemicals I can&#039;t recognize.  All these extra steps make my grocery trips almost as much of an information-overload as the most recent graduate seminar in the department. 

In fact, when I am running short of time, my groceries consist of almost entirely fresh produce (that don&#039;t have any labels on them that I might be tempted to scrutinize). I think its funny that, to avoid the tedium of agonizing over unproven disease-exposure links while I am grocery shopping, I have unconsciously made a choice of just getting things that are somewhat uncontroversial -- &lt;a href=&quot;http://www.foodnews.org/fulllist.php&quot; title=&quot;Pesticide Levels in Produce&quot; rel=&quot;nofollow&quot;&gt;well, almost&lt;/a&gt;.</description>
		<content:encoded><![CDATA[<p>Interesting post. It makes me think about how my field of work/study influences my trips to the grocery store. I consciously veer away from the snack aisle, read those zillion fine-print labels on everything to make sure they don&#8217;t have hydrogenated vegetable oils or high-fructose corn syrup or MSG or preservatives/chemicals I can&#8217;t recognize.  All these extra steps make my grocery trips almost as much of an information-overload as the most recent graduate seminar in the department. </p>
<p>In fact, when I am running short of time, my groceries consist of almost entirely fresh produce (that don&#8217;t have any labels on them that I might be tempted to scrutinize). I think its funny that, to avoid the tedium of agonizing over unproven disease-exposure links while I am grocery shopping, I have unconsciously made a choice of just getting things that are somewhat uncontroversial &#8212; <a href="http://www.foodnews.org/fulllist.php" title="Pesticide Levels in Produce" rel="nofollow">well, almost</a>.</p>
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		<title>By: Ruth Seeley</title>
		<link>http://2020science.org/2009/10/11/is-too-much-choice-bad-for-the-health/comment-page-1/#comment-32097</link>
		<dc:creator>Ruth Seeley</dc:creator>
		<pubDate>Sun, 11 Oct 2009 13:36:52 +0000</pubDate>
		<guid isPermaLink="false">http://2020science.org/?p=2311#comment-32097</guid>
		<description>Well, not a &#039;this Monday&#039; decision anyway, since it&#039;ll be Thanksgiving in Canada and Columbus Day in the US. A week Monday perhaps.

Last week I got embroiled in an extremely unsatisfying discussion on another blog relating to vaccinations in general. I pointed out that not even the concept of &#039;herd immunity&#039; is currently understood by the general public, although, having minimally researched it, I&#039;m seeing oblique references to it in statements made to media by public health officials in an attempt to persuade all Canadians to get the H1N1 vaccine. The point I tried to make on the other blog was that, if you want 90% of any given population to do something, you&#039;re either going to have to persuade them or you&#039;re going to have  to introduce legislation to force them to do what you want them to do. (And yes, I do realize the &#039;herd immunization&#039; level varies from virus to virus, and that it can be achieved by getting the virus as well as via vaccination.) 

I&#039;m also seeing various polls of and interviews with ordinary Canadians who are very torn about whether to get the H1N1 vaccine or not, and I certainly understand their dilemma. They&#039;re going through the same process as you with the croissants vs the McGriddle: looking at the info and asking themselves if they&#039;re in a high risk group or not, evaluating precautionary measures and determining whether they&#039;re too onerous for them to implement  while trying to figure out how bad it would be if they got swine flu, trying to weigh the odds of their getting seasonal flu and whether they&#039;ll increase if they get the swine flu vaccination. There is an undercurrent, although it&#039;s been unstated, of trying to evaluate one&#039;s civic duty in this situation as well, given the H1N1 virus&#039;s quite long contagious period.

I think what perturbs me most about what&#039;s surfacing is another unstated belief that seems to permeate the developed world these days, which is that we shouldn&#039;t ever get sick, and if we do as a result of a virus, the &#039;system&#039; has let us down. That coupled with a work ethic in North America that implies you&#039;re slacking if you&#039;re not available 24/7 or have the temerity to actually stay home when you&#039;re sick - and that the number of sick days you take will be used against you in an uncertain economy - are extremely disturbing. 

I don&#039;t think a decision-making aid process would be such a bad idea, really, as long as it was comprehensive, and included some tough questions like, &#039;Are you prepared to remain in quarantine even if you get sick over the festive season?&#039; &#039;Do you have anyone to look after you if you do get swine flu?&#039; and &#039;Can you afford to take a week&#039;s sick leave?&#039; as well as, &#039;Do you have health insurance in case you have an unknown underlying condition that means you end up in hospital with swine flu?&#039;</description>
		<content:encoded><![CDATA[<p>Well, not a &#8216;this Monday&#8217; decision anyway, since it&#8217;ll be Thanksgiving in Canada and Columbus Day in the US. A week Monday perhaps.</p>
<p>Last week I got embroiled in an extremely unsatisfying discussion on another blog relating to vaccinations in general. I pointed out that not even the concept of &#8216;herd immunity&#8217; is currently understood by the general public, although, having minimally researched it, I&#8217;m seeing oblique references to it in statements made to media by public health officials in an attempt to persuade all Canadians to get the H1N1 vaccine. The point I tried to make on the other blog was that, if you want 90% of any given population to do something, you&#8217;re either going to have to persuade them or you&#8217;re going to have  to introduce legislation to force them to do what you want them to do. (And yes, I do realize the &#8216;herd immunization&#8217; level varies from virus to virus, and that it can be achieved by getting the virus as well as via vaccination.) </p>
<p>I&#8217;m also seeing various polls of and interviews with ordinary Canadians who are very torn about whether to get the H1N1 vaccine or not, and I certainly understand their dilemma. They&#8217;re going through the same process as you with the croissants vs the McGriddle: looking at the info and asking themselves if they&#8217;re in a high risk group or not, evaluating precautionary measures and determining whether they&#8217;re too onerous for them to implement  while trying to figure out how bad it would be if they got swine flu, trying to weigh the odds of their getting seasonal flu and whether they&#8217;ll increase if they get the swine flu vaccination. There is an undercurrent, although it&#8217;s been unstated, of trying to evaluate one&#8217;s civic duty in this situation as well, given the H1N1 virus&#8217;s quite long contagious period.</p>
<p>I think what perturbs me most about what&#8217;s surfacing is another unstated belief that seems to permeate the developed world these days, which is that we shouldn&#8217;t ever get sick, and if we do as a result of a virus, the &#8216;system&#8217; has let us down. That coupled with a work ethic in North America that implies you&#8217;re slacking if you&#8217;re not available 24/7 or have the temerity to actually stay home when you&#8217;re sick &#8211; and that the number of sick days you take will be used against you in an uncertain economy &#8211; are extremely disturbing. </p>
<p>I don&#8217;t think a decision-making aid process would be such a bad idea, really, as long as it was comprehensive, and included some tough questions like, &#8216;Are you prepared to remain in quarantine even if you get sick over the festive season?&#8217; &#8216;Do you have anyone to look after you if you do get swine flu?&#8217; and &#8216;Can you afford to take a week&#8217;s sick leave?&#8217; as well as, &#8216;Do you have health insurance in case you have an unknown underlying condition that means you end up in hospital with swine flu?&#8217;</p>
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